Basic Information
Provider Information
NPI: 1588062046
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ASBERRY
FirstName: GIAVANNI
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 770 WOODLANE ROAD
Address2:  
City: MT. HOLLY
State: NJ
PostalCode: 08060
CountryCode: US
TelephoneNumber: 6092675928
FaxNumber:  
Practice Location
Address1: 9 PHILLIPS RD
Address2:  
City: HAINESPORT
State: NJ
PostalCode: 080364874
CountryCode: US
TelephoneNumber: 6092675928
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/16/2014
LastUpdateDate: 12/16/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X26NR17273100NJY Nursing Service ProvidersRegistered Nurse 

No ID Information.


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