Provider Demographics
NPI:1225223837
Name:GIORDANO, PETER (LAC, LMT)
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:
Last Name:GIORDANO
Suffix:
Gender:M
Credentials:LAC, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 W 19TH ST STE 1103
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-4128
Mailing Address - Country:US
Mailing Address - Phone:631-905-6870
Mailing Address - Fax:
Practice Address - Street 1:151 W 19TH ST STE 1103
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-4128
Practice Address - Country:US
Practice Address - Phone:631-905-6870
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-07
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020301225700000X
NY004995171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist