Provider Demographics
NPI:1407049604
Name:GIORDANO, LUCA (MD)
Entity Type:Individual
Prefix:
First Name:LUCA
Middle Name:
Last Name:GIORDANO
Suffix:
Gender:M
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:PO BOX 8500-6335
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-0001
Mailing Address - Country:US
Mailing Address - Phone:215-807-8000
Mailing Address - Fax:215-807-8235
Practice Address - Street 1:3998 RED LION RD
Practice Address - Street 2:SUITE 125
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19114-1436
Practice Address - Country:US
Practice Address - Phone:215-824-4559
Practice Address - Fax:215-612-9220
Is Sole Proprietor?:No
Enumeration Date:2007-08-21
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD070043L208600000X, 2086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1019872790002Medicaid
PA2678868OtherAETNA
PA2870102000OtherPERSONAL CHOICE
PA1472455OtherHIGHMARK BLUE SHIELD
PA38409OtherHEALTH PARTNERS
PA30044882OtherKEYSTONE MERCY
PA2870102000OtherKEYSTONE IBC
PA1019872790002Medicaid