| Doctor Name: | MRS. MARY DEGIOVINE |
| NPI Number: | 1043314651 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 79 Middleville Rd Vamc 116b-vr Northport, NY - 117682200 |
| Business Phone Number: | 6312614400 |
| Business Fax Number: | 6312666011 |
| Mailing Address: | 79 Middleville Rd, NORTHPORT |
| State: | NY |
| Postal Code: | 117682200 |
| Phone Number: | 6312614400 |
| Fax Number: | |
| NPI Enumeration Date: | 09/12/2006 |
| NPI Last Update Date: | 07/12/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |