Provider Demographics
NPI:1215144811
Name:MARIEANNE GIARDINA-BECKETT MD
Entity type:Organization
Organization Name:MARIEANNE GIARDINA-BECKETT MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIEANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:GIARDINA-BECKETT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-348-8911
Mailing Address - Street 1:1 HARMON PLZ
Mailing Address - Street 2:
Mailing Address - City:SECAUCUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07094-2803
Mailing Address - Country:US
Mailing Address - Phone:201-348-8911
Mailing Address - Fax:201-348-2169
Practice Address - Street 1:1 HARMON PLZ
Practice Address - Street 2:
Practice Address - City:SECAUCUS
Practice Address - State:NJ
Practice Address - Zip Code:07094-2803
Practice Address - Country:US
Practice Address - Phone:201-348-8911
Practice Address - Fax:201-348-2169
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2007-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ064695Medicare ID - Type Unspecified