Healthcare Provider Details

I. General information

NPI: 1053578831
Provider Name (Legal Business Name): KEVIN THOMAS GIOIA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2008
Last Update Date: 06/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 AVENUE OF TWO RIVERS
RUMSON NJ
07760-1802
US

IV. Provider business mailing address

108 AVENUE OF TWO RIVERS
RUMSON NJ
07760-1802
US

V. Phone/Fax

Practice location:
  • Phone: 732-263-7903
  • Fax: 732-263-7905
Mailing address:
  • Phone: 732-263-7903
  • Fax: 732-263-7905

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number25MA09916800
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code2088F0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Urology) Physician
License Number25MA09916800
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberMD60453256
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: