Provider Demographics
NPI:1053578831
Name:GIOIA, KEVIN THOMAS (MD)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:THOMAS
Last Name:GIOIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 AVENUE OF TWO RIVERS
Mailing Address - Street 2:
Mailing Address - City:RUMSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07760-1802
Mailing Address - Country:US
Mailing Address - Phone:732-263-7903
Mailing Address - Fax:732-263-7905
Practice Address - Street 1:108 AVENUE OF TWO RIVERS
Practice Address - Street 2:
Practice Address - City:RUMSON
Practice Address - State:NJ
Practice Address - Zip Code:07760-1802
Practice Address - Country:US
Practice Address - Phone:732-263-7903
Practice Address - Fax:732-263-7905
Is Sole Proprietor?:No
Enumeration Date:2008-05-20
Last Update Date:2019-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09916800208800000X, 2088F0040X
390200000X
WAMD60453256208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No2088F0040XAllopathic & Osteopathic PhysiciansUrologyUrogynecology and Reconstructive Pelvic Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program