Provider Demographics
NPI:1194750638
Name:GIARDINA, PATRICIA JANE (CNM)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:JANE
Last Name:GIARDINA
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:740 WILLIAMS ST
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-7463
Mailing Address - Country:US
Mailing Address - Phone:413-442-2226
Mailing Address - Fax:413-442-1314
Practice Address - Street 1:777 NORTH ST
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-4147
Practice Address - Country:US
Practice Address - Phone:413-499-8570
Practice Address - Fax:413-499-8565
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2018-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA176495174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0392430Medicaid
MACN0134OtherBLUE CROSS BLUE SHIELD
MA10694OtherHEALTH NEW ENGLAND
MAAA41739OtherHARVARD PILGRIM HEALTH
MA10694OtherHEALTH NEW ENGLAND
MA0392430Medicaid