Provider Demographics
NPI:1982846507
Name:MINERVINI, GIANMARIA (MD)
Entity Type:Individual
Prefix:MR
First Name:GIANMARIA
Middle Name:
Last Name:MINERVINI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1062 LANCASTER AVE
Mailing Address - Street 2:APT 620
Mailing Address - City:ROSEMONT
Mailing Address - State:PA
Mailing Address - Zip Code:19010
Mailing Address - Country:US
Mailing Address - Phone:610-564-2989
Mailing Address - Fax:
Practice Address - Street 1:1062 LANCASTER AVE
Practice Address - Street 2:APT 620
Practice Address - City:ROSEMONT
Practice Address - State:PA
Practice Address - Zip Code:19010
Practice Address - Country:US
Practice Address - Phone:610-564-2989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-27
Last Update Date:2009-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD019291E208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics