Provider Demographics
NPI:1093603250
Name:GIORDANO, MARYANNE REGINA (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:MARYANNE
Middle Name:REGINA
Last Name:GIORDANO
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:MARYANNE
Other - Middle Name:REGINA
Other - Last Name:PRESTAMO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:REGISTERED NURSE
Mailing Address - Street 1:24 GRIFFEN ST
Mailing Address - Street 2:
Mailing Address - City:POUGHQUAG
Mailing Address - State:NY
Mailing Address - Zip Code:12570-5201
Mailing Address - Country:US
Mailing Address - Phone:914-469-0466
Mailing Address - Fax:
Practice Address - Street 1:56 SUN UP RD
Practice Address - Street 2:
Practice Address - City:STORMVILLE
Practice Address - State:NY
Practice Address - Zip Code:12582-5124
Practice Address - Country:US
Practice Address - Phone:914-621-1760
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-26
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY334946-01163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse