1356562573 NPI number — LISA GIONI M.D.

Table of content: LISA GIONI M.D. (NPI 1356562573)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356562573 NPI number — LISA GIONI M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GIONI
Provider First Name:
LISA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ROMAGNOLI
Provider Other First Name:
LISA
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1356562573
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/21/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
141 LONGWATER DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORWELL
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02061-1632
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
781-878-5200
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
51 PERFORMANCE DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WEYMOUTH
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02189-3141
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
781-682-8000
Provider Business Practice Location Address Fax Number:
781-335-1412
Provider Enumeration Date:
05/02/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X , with the licence number:  241810 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 042297845 . This is a "TRICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: AA148267 . This is a "HARVARD PILGRIM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 042297845 . This is a "GIC/UNICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 110082956A , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 9872385 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 001251001 . This is a "MEDICARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 042297845 . This is a "GREAT WEST HEALTH CARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1356562573 . This is a "FALLON" identifier . This identifiers is of the category "OTHER".
  • Identifier: 753430 . This is a "TUFTS AND TUFTS MEDICARE PREFERRED" identifier . This identifiers is of the category "OTHER".
  • Identifier: SS0064 . This is a "BCBSMA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 042297845 . This is a "UNITED HEALTH CARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1356562573 . This is a "NEIGHBORHOOD HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 042297845 . This is a "PHCS/MULTI-PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 042297845 . This is a "HCVM/COVENTRY/FIRST HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7709205 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".




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