Provider Demographics
NPI:1457316143
Name:GIARDINA, VINCENT V (DC)
Entity Type:Individual
Prefix:MR
First Name:VINCENT
Middle Name:V
Last Name:GIARDINA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:864 ROUTE 37 W
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-5033
Mailing Address - Country:US
Mailing Address - Phone:732-503-4079
Mailing Address - Fax:732-503-4127
Practice Address - Street 1:864 ROUTE 37 W
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-5033
Practice Address - Country:US
Practice Address - Phone:732-503-4079
Practice Address - Fax:732-503-4127
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC04797111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ083449YETNOtherMEDICARE PTAN
NJT23626Medicare UPIN
NJ83449Medicare ID - Type Unspecified