Provider Demographics
NPI:1376678953
Name:GIORDANO, EILEEN P (MA,CCC,LSP)
Entity Type:Individual
Prefix:
First Name:EILEEN
Middle Name:P
Last Name:GIORDANO
Suffix:
Gender:F
Credentials:MA,CCC,LSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 WOODBROOK DR
Mailing Address - Street 2:
Mailing Address - City:RIDGE
Mailing Address - State:NY
Mailing Address - Zip Code:11961-2133
Mailing Address - Country:US
Mailing Address - Phone:516-983-5409
Mailing Address - Fax:
Practice Address - Street 1:33 WOODBROOK DR
Practice Address - Street 2:
Practice Address - City:RIDGE
Practice Address - State:NY
Practice Address - Zip Code:11961-2133
Practice Address - Country:US
Practice Address - Phone:516-983-5409
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0072441235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist