Healthcare Provider Details

I. General information

NPI: 1285617209
Provider Name (Legal Business Name): ROBERT JOSEPH GEMIGNANI JR. DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/23/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1326 SOUTH GOVERNORS AVENUE SUITE 1B
DOVER DE
19907
US

IV. Provider business mailing address

1326 SOUTH GOVERNORS AVENUE SUITE 1B
DOVER DE
19907
US

V. Phone/Fax

Practice location:
  • Phone: 302-678-3338
  • Fax: 302-678-5538
Mailing address:
  • Phone: 302-678-3338
  • Fax: 302-678-5538

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberE10000114
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: