Individual
JEROME VINCENT GIOVINAZZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1460 VICTORY BLVD, STATEN ISLAND, NY 10301-3914
(718) 447-0022
Mailing address
1460 VICTORY BLVD, STATEN ISLAND, NY 10301-3914
(718) 447-0022
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MT204998
PA
207W00000X
Ophthalmology Physician
Primary
276893
NY
390200000X
Student in an Organized Health Care Education/Training Program
MT204998
PA
Other
Enumeration date
06/10/2013
Last updated
09/18/2019
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