Provider Demographics
NPI:1003784661
Name:DIODATI, GINA
Entity type:Individual
Prefix:
First Name:GINA
Middle Name:
Last Name:DIODATI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:580 STAUNTON COMMONS DR APT F5
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:OH
Mailing Address - Zip Code:45373-2175
Mailing Address - Country:US
Mailing Address - Phone:937-548-1635
Mailing Address - Fax:
Practice Address - Street 1:580 STAUNTON COMMONS DR APT F5
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:OH
Practice Address - Zip Code:45373-2175
Practice Address - Country:US
Practice Address - Phone:937-548-1635
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-27
Last Update Date:2025-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty