Provider Demographics
NPI:1861759870
Name:GIURINTANO, JONATHAN PETER (MD)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:PETER
Last Name:GIURINTANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1321 R ST NW APT 4
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-4372
Mailing Address - Country:US
Mailing Address - Phone:601-863-6371
Mailing Address - Fax:
Practice Address - Street 1:3800 RESERVOIR RD NW BLDG 1
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20007
Practice Address - Country:US
Practice Address - Phone:202-444-8186
Practice Address - Fax:877-826-5501
Is Sole Proprietor?:No
Enumeration Date:2012-04-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA145217207Y00000X
390200000X
DCMD046063207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA$$$$$$$$$Medicaid