Gina M. Iaciofano, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

ISW02121 Issued in RI

Legal business name

GINA M. IACIOFANO, LLC

Practice address

1920 Mineral Spring Ave
Unit 9
North Providence, RI 02904-3742

Phone

(401) 497-6500

NPI assigned

Apr 24, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Gina M Iaciofano, LICSW

Title

Clinical Social Worker

Phone

(401) 497-6500

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1335225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335225600000",
    "number": "1437417839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1920 MINERAL SPRING AVE",
            "address_2": "UNIT 9",
            "city": "NORTH PROVIDENCE",
            "state": "RI",
            "postal_code": "029043742",
            "telephone_number": "401-497-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 MINERAL SPRING AVE",
            "address_2": "UNIT 9",
            "city": "NORTH PROVIDENCE",
            "state": "RI",
            "postal_code": "029043742",
            "telephone_number": "401-497-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GINA M. IACIOFANO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-24",
        "last_updated": "2012-04-24",
        "status": "A",
        "authorized_official_last_name": "IACIOFANO",
        "authorized_official_first_name": "GINA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "401-497-6500",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "RI",
            "license": "ISW02121",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "002186701",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GI84855",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Ian Giuttari, DC
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• Cecilia A. Gmuer, MD
• Ronald C Gobeil, DO
• David Julian Goldstein, D.O.

• Community/Behavioral Health Agency in North Providence, RI
• Providers in North Providence, RI by specialty
• Community/Behavioral Health Agency in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.