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General NPI Number Information
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NPI Number | 1730893827
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Entity Type | Individual
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Provider Name | GINA DEMAIOLO
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Gender | Female
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Dates
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Enumeration Date | 01/12/2023
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Last Update Date | 01/27/2023
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Provider Practice Location Address
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Address Line | 176 VIRGINIA AVE
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City | ROCHESTER
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State | PA
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Zip | 15074-1723
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Country | US
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Telephone | 724-770-9095
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Fax | 724-770-9096
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Provider Business Mailing Address
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Address Line | 100 SHENANGO AVE
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City | SHARON
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State | PA
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Zip | 16146-1503
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Country | US
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Telephone | 724-770-9095
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Fax | 724-770-9096
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN639623
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | SP026715
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License Number State | PA
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