Provider Demographics
NPI:1144387887
Name:GIORDANO, JOAN (MD)
Entity Type:Individual
Prefix:DR
First Name:JOAN
Middle Name:
Last Name:GIORDANO
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 1:20 HARTFORD RD STE 4
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:CT
Mailing Address - Zip Code:06420-3800
Mailing Address - Country:US
Mailing Address - Phone:860-691-0302
Mailing Address - Fax:860-451-8175
Practice Address - Street 1:20 HARTFORD RD STE 4
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:CT
Practice Address - Zip Code:06420-3800
Practice Address - Country:US
Practice Address - Phone:860-691-0302
Practice Address - Fax:860-451-8175
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT031525207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001315250Medicaid
E30616Medicare UPIN
CTD400012325Medicare PIN