Provider Demographics
NPI:1932565660
Name:GIARDINA, VINCENT JR (MA)
Entity type:Individual
Prefix:MR
First Name:VINCENT
Middle Name:
Last Name:GIARDINA
Suffix:JR
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 ELENA CT
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08055-9175
Mailing Address - Country:US
Mailing Address - Phone:609-314-1367
Mailing Address - Fax:
Practice Address - Street 1:1 ELENA CT
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:NJ
Practice Address - Zip Code:08055-9175
Practice Address - Country:US
Practice Address - Phone:609-314-1367
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-11
Last Update Date:2016-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator