Provider Demographics
NPI:1427052083
Name:GIOVANNINI, SHEILA (MA, CCC-A)
Entity type:Individual
Prefix:MS
First Name:SHEILA
Middle Name:
Last Name:GIOVANNINI
Suffix:
Gender:F
Credentials:MA, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 WILLIAM ST
Mailing Address - Street 2:
Mailing Address - City:ELMIRA
Mailing Address - State:NY
Mailing Address - Zip Code:14901-2829
Mailing Address - Country:US
Mailing Address - Phone:607-734-0494
Mailing Address - Fax:607-734-0880
Practice Address - Street 1:301 WILLIAM ST
Practice Address - Street 2:
Practice Address - City:ELMIRA
Practice Address - State:NY
Practice Address - Zip Code:14901-2829
Practice Address - Country:US
Practice Address - Phone:607-734-0494
Practice Address - Fax:607-734-0880
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-10
Last Update Date:2007-10-11
Deactivation Date:2006-03-16
Deactivation Code:
Reactivation Date:2006-03-22
Provider Licenses
StateLicense IDTaxonomies
NY000783231H00000X
NY14000000850237600000X, 231HA2400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01214584Medicaid
NY01214584Medicaid
NY52379CMedicare PIN