NPI 1740883719

Giavanna Desimone, LATATC

Practitioner Athletic Trainer Ridgewood, NJ

Practice location

Address: 321 Goffle Rd, Ridgewood, NJ 07450-4033
Phone: (201) 206-1516

Registered specialties

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X Licence 25MT00264900 (NJ)

Other Specialist/Technologist providers in New Jersey →

Registry record

NPI: 1740883719
Entity type: Individual
Sex (as registered): Female
NPI issued: 20 Nov 2020
Record last updated: 20 Nov 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.