Basic Information
| Provider Information | |||||||||
| NPI: | 1811962111 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GIUNTI | ||||||||
| FirstName: | GENE | ||||||||
| MiddleName: | JOSEPH | ||||||||
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| NameSuffix: | |||||||||
| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 30 CHASE AVE | ||||||||
| Address2: | CENTER FOR HEALTH AND REHABILITATION | ||||||||
| City: | WATERVILLE | ||||||||
| State: | ME | ||||||||
| PostalCode: | 049014624 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2078724400 | ||||||||
| FaxNumber: | 2078724651 | ||||||||
| Practice Location | |||||||||
| Address1: | 30 CHASE AVE | ||||||||
| Address2: | CENTER FOR HEALTH AND REHABILITATION | ||||||||
| City: | WATERVILLE | ||||||||
| State: | ME | ||||||||
| PostalCode: | 049014624 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2078724400 | ||||||||
| FaxNumber: | 2078724651 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/21/2006 | ||||||||
| LastUpdateDate: | 03/29/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | 01805 | ME | Y | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
ID Information
| ID | Type | State | Issuer | Description | 010424957 | 01 | EMPLOY STANDARDS | OTHER | 060992 | 01 | BCBS | OTHER | 010424957 | 01 | TRICARE | OTHER | 6179031 | 01 | CIGNA | OTHER | 1811962111 | 05 | ME | MEDICAID | 010424957 | 01 | CHAMPUS | OTHER | 288270099 | 05 | ME | MEDICAID | AA2004 | 01 | HARVARD PILGRIM | OTHER | 010424957 | 01 | STANDARD TAX ID | OTHER | 3678813 | 01 | AETNA | OTHER |