Provider Demographics
NPI:1043492044
Name:GIORDANO, ANTHONY J (RPH)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:J
Last Name:GIORDANO
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:178 NEW HYDE PARK RD
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN SQUARE
Mailing Address - State:NY
Mailing Address - Zip Code:11010-3012
Mailing Address - Country:US
Mailing Address - Phone:516-775-4294
Mailing Address - Fax:
Practice Address - Street 1:178 NEW HYDE PARK RD
Practice Address - Street 2:
Practice Address - City:FRANKLIN SQUARE
Practice Address - State:NY
Practice Address - Zip Code:11010-3012
Practice Address - Country:US
Practice Address - Phone:516-775-4294
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-30
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028684183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00703324Medicaid