Provider Demographics
NPI:1316249204
Name:GIORDANO, THERESA A (RPH)
Entity type:Individual
Prefix:
First Name:THERESA
Middle Name:A
Last Name:GIORDANO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-6672
Mailing Address - Country:US
Mailing Address - Phone:212-255-6100
Mailing Address - Fax:
Practice Address - Street 1:56 7TH AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-6672
Practice Address - Country:US
Practice Address - Phone:212-255-6100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-27
Last Update Date:2017-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY050413-1183500000X
NJ28RI02809700183500000X
MN118426183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist