Provider Demographics
NPI:1144307679
Name:DR JM DIGIROLAMO PC
Entity type:Organization
Organization Name:DR JM DIGIROLAMO PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:M
Authorized Official - Last Name:DIGIROLAMO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:434-977-2020
Mailing Address - Street 1:2159 BARRACKS RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22903-4812
Mailing Address - Country:US
Mailing Address - Phone:434-977-2020
Mailing Address - Fax:434-977-4842
Practice Address - Street 1:2159 BARRACKS RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22903-4812
Practice Address - Country:US
Practice Address - Phone:434-977-2020
Practice Address - Fax:434-977-4842
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC08288Medicare PIN
VA4497220001Medicare NSC