Provider Demographics
NPI:1053972067
Name:GIORDANO, GIANNA MARIE (PA-C)
Entity type:Individual
Prefix:
First Name:GIANNA
Middle Name:MARIE
Last Name:GIORDANO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 ASPINWALL ST
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10307-1627
Mailing Address - Country:US
Mailing Address - Phone:718-702-3401
Mailing Address - Fax:
Practice Address - Street 1:682 FOREST AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10310-2507
Practice Address - Country:US
Practice Address - Phone:718-370-9412
Practice Address - Fax:718-698-9412
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-21
Last Update Date:2019-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant