Provider Demographics
NPI:1265435432
Name:DIGIOVANNI, LOUIS A (MD)
Entity type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:A
Last Name:DIGIOVANNI
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:PO BOX 2000
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:12534-2000
Mailing Address - Country:US
Mailing Address - Phone:518-828-8363
Mailing Address - Fax:518-697-3388
Practice Address - Street 1:23 FISH AND GAME RD
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:NY
Practice Address - Zip Code:12534-3815
Practice Address - Country:US
Practice Address - Phone:518-828-7644
Practice Address - Fax:518-828-2320
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2011-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY142487207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYB15303Medicare UPIN
NYWKB781Medicare ID - Type UnspecifiedGROUP NUMBER
NY49A6379533Medicare PIN