Provider Demographics
NPI:1134017866
Name:SERIO, GINO (PR)
Entity type:Individual
Prefix:
First Name:GINO
Middle Name:
Last Name:SERIO
Suffix:
Gender:M
Credentials:PR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:332 12TH ST APT 208
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701-1569
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:304-756-8230
Practice Address - Street 1:137 8TH AVE W
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701-2510
Practice Address - Country:US
Practice Address - Phone:304-408-3256
Practice Address - Fax:304-756-8230
Is Sole Proprietor?:No
Enumeration Date:2025-06-24
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV25-939175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist