1194159863 NPI number — MRS. GINA PERRONE ACA, BC-HIS

Table of content: MRS. GINA PERRONE ACA, BC-HIS (NPI 1194159863)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194159863 NPI number — MRS. GINA PERRONE ACA, BC-HIS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PERRONE
Provider First Name:
GINA
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
ACA, BC-HIS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SUGZDINIS
Provider Other First Name:
GINA
Provider Other Middle Name:
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
ACA, BC-HIS
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1194159863
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/20/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1920 QUAKER RIDGE DR
Provider Second Line Business Mailing Address:
HEARING HEALTH CENTER
Provider Business Mailing Address City Name:
GREEN COVE SPRINGS
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32043-8089
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
302-229-6883
Provider Business Mailing Address Fax Number:
302-529-1045

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1920 QUAKER RIDGE DR
Provider Second Line Business Practice Location Address:
HEARING HEALTH CENTER
Provider Business Practice Location Address City Name:
GREEN COVE SPRINGS
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32043-8089
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
302-229-6883
Provider Business Practice Location Address Fax Number:
302-529-1045
Provider Enumeration Date:
08/29/2013

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: 237700000X , with the licence number:  25MG00092600 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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