Provider Demographics
NPI:1497756936
Name:GIRARDY, JAMES D (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:D
Last Name:GIRARDY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:120 EAGLE ROCK AVE STE 154
Mailing Address - Street 2:
Mailing Address - City:EAST HANOVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07936-3168
Mailing Address - Country:US
Mailing Address - Phone:201-407-5145
Mailing Address - Fax:862-701-6444
Practice Address - Street 1:120 EAGLE ROCK AVE
Practice Address - Street 2:SUITE 154
Practice Address - City:EAST HANOVER
Practice Address - State:NJ
Practice Address - Zip Code:07936-3158
Practice Address - Country:US
Practice Address - Phone:201-407-5145
Practice Address - Fax:862-701-6444
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07056000208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8221812OtherGHI PPO #
NJ7444395OtherAETNA PPO #
NJ2K7635OtherHEALTHNET#
NJ2851877000OtherAMERIHEALTH #
NJP00132442OtherRR MDCR #
NJP3362187OtherOXFORD#
NJP00132442OtherRR MDCR #
NJ2851877000OtherAMERIHEALTH #