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NPI Code Detail

MEDICARE: GINA MARIE BUIOCCHI

MEDICARE: GINA MARIE BUIOCCHI
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
1390200000XStudent in an Organized Health Care Education/Training ProgramI009607AZ

General Provider Information

NPI Number : 1740558881
Entity Type Code : Individual
Provider Name (Legal Business Name) : GINA MARIE BUIOCCHI
Provider Business Mailing Address
First Line : 6234 W BEHREND DR.
Second Line : APT. 3108
City : GLENDALE
State : AZ
Zip : 85308
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 744 W CAMELBACK RD
Second Line :
City : PHOENIX
State : AZ
Zip : 85013-2207
Country : US
Telephone Number : 602-279-9337
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/04/2011
Last Update Date : 12/04/2011

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Directions to “ GINA MARIE BUIOCCHI ” Practice Location

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