Provider Demographics
NPI:1396077228
Name:GIORDANO, VINCENT J (RPH)
Entity type:Individual
Prefix:MR
First Name:VINCENT
Middle Name:J
Last Name:GIORDANO
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1660 WALT WHITMAN RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-4159
Mailing Address - Country:US
Mailing Address - Phone:800-218-5604
Mailing Address - Fax:800-218-4924
Practice Address - Street 1:1660 WALT WHITMAN RD
Practice Address - Street 2:SUITE 105
Practice Address - City:MELVILLE
Practice Address - State:NY
Practice Address - Zip Code:11747-4159
Practice Address - Country:US
Practice Address - Phone:800-218-5604
Practice Address - Fax:800-218-4924
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-03
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY048609183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY048609OtherSTATE LICENSE NUMBER