1184683815 NPI number — DR. JOSEPH VICTOR GIRGENTI O.D.

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184683815 NPI number — DR. JOSEPH VICTOR GIRGENTI O.D.

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

GIRGENTI

Provider First Name:

JOSEPH

Provider Middle Name:

VICTOR

Provider Name Prefix Text:

DR.

Provider Name Suffix Text:

Provider Credential Text:

O.D.

Provider Gender Code:

M

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1184683815

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

07/11/2023

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

17 VILLAGE PLAZA WAY

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

N SCITUATE

Provider Business Mailing Address State Name:

RI

Provider Business Mailing Address Postal Code:

02857-1849

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

401-934-2800

Provider Business Mailing Address Fax Number:

Provider First Line Business Practice Location Address:

17 VILLAGE PLAZA WAY

Provider Second Line Business Practice Location Address:

BOX 4

Provider Business Practice Location Address City Name:

N SCITUATE

Provider Business Practice Location Address State Name:

RI

Provider Business Practice Location Address Postal Code:

02857-1849

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

401-934-2800

Provider Business Practice Location Address Fax Number:

Provider Enumeration Date:

03/21/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 152W00000X , with the licence number:  ODTA00432 , registered in the state of RI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 2200088 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
• Identifier: 461497 . This is a "AETNA US HEALTHCARE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
• Identifier: 78308 . This is a "RI PLAN 65" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
• Identifier: 78308 . This is a "RI FEDERAL BLUE CROSS" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
• Identifier: 2200088 . This is a "OXFORD HEALTH PLANS" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
• Identifier: 410048380 . This is a "RAILROAD RETIREE" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
• Identifier: 9007947 , issued by the state of ( RI ) . This identifiers is of the category "MEDICAID".
• Identifier: 2200088 . This is a "UNITED HEALTH CARE OF N.E" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
• Identifier: 2874 , issued by the state of ( RI ) . This identifiers is of the category "MEDICAID".
• Identifier: 050497755 . This is a "CIGNA HEALTHCARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 201880 . This is a "BLUE CHIP" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
• Identifier: 78308 . This is a "RI BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".