Provider Demographics
NPI:1588055156
Name:GIRARDY, JEANNE ELIZABETH (MD)
Entity type:Individual
Prefix:DR
First Name:JEANNE
Middle Name:ELIZABETH
Last Name:GIRARDY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 CLYDE RD STE 102
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-5039
Mailing Address - Country:US
Mailing Address - Phone:732-246-7440
Mailing Address - Fax:732-249-5951
Practice Address - Street 1:27 CLYDE RD STE 102
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-5039
Practice Address - Country:US
Practice Address - Phone:732-246-7440
Practice Address - Fax:732-249-5951
Is Sole Proprietor?:No
Enumeration Date:2015-02-18
Last Update Date:2015-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06778100207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine