MEDICARE: LAURA DIGIOVANNI PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1275839722
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA DIGIOVANNI PH.D.

Provider Business Mailing Address
First Line	:	5 WINDHAM LOOP
Second Line	:	APARTMENT 5I
City	:	STATEN ISLAND
State	:	NY
Zip	:	10314-5958
Country	:	US
Telephone Number	:	917-355-0276
Fax Number	:

Provider Business Practice Location Address
First Line	:	5 WINDHAM LOOP
Second Line	:	APARTMENT 5I
City	:	STATEN ISLAND
State	:	NY
Zip	:	10314-5958
Country	:	US
Telephone Number	:	917-355-0276
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/01/2011
Last Update Date	:	02/01/2011

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