Provider Demographics
NPI:1588975445
Name:GIOVINAZZO, THOMAS MICHAEL (PHARMD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:MICHAEL
Last Name:GIOVINAZZO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1179 VESTAL AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13903-1606
Mailing Address - Country:US
Mailing Address - Phone:607-723-7584
Mailing Address - Fax:
Practice Address - Street 1:1188 VESTAL AVE
Practice Address - Street 2:
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13903-1612
Practice Address - Country:US
Practice Address - Phone:607-723-7584
Practice Address - Fax:607-773-0936
Is Sole Proprietor?:No
Enumeration Date:2010-06-25
Last Update Date:2011-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY054551183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist