Provider Demographics
NPI:1114953676
Name:GIORGIANNI, NICHOLAS J JR (DPM)
Entity type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:J
Last Name:GIORGIANNI
Suffix:JR
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 BERLIN RD
Mailing Address - Street 2:SUITE 5000
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034-3574
Mailing Address - Country:US
Mailing Address - Phone:856-795-1003
Mailing Address - Fax:856-795-5994
Practice Address - Street 1:52 BERLIN RD
Practice Address - Street 2:SUITE 5000
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-3574
Practice Address - Country:US
Practice Address - Phone:856-795-1003
Practice Address - Fax:856-795-5994
Is Sole Proprietor?:No
Enumeration Date:2006-06-24
Last Update Date:2013-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMD00240700213E00000X
PASC004298L213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5104529OtherCIGNA
NJ60019057OtherHORIZON NJ HEALTH
NJP00362739OtherRAIL ROAD MEDICARE
NJP3692970OtherOXFORD
NJ3958366OtherAETNA HMO
NJ7839600Medicaid
NJ000955659OtherPA BLUE SHIELD
NJ5151574OtherCIGNA
NJ0464331000OtherAMERIHEALTH
NJ955659AL1Medicare PIN
NJ5151574OtherCIGNA
NJ5104529OtherCIGNA