Provider Demographics
NPI:1568564037
Name:GIARDINO, SUSAN (NP)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:
Last Name:GIARDINO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6101 ROBINSON RD
Mailing Address - Street 2:
Mailing Address - City:LOCKPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14094-8920
Mailing Address - Country:US
Mailing Address - Phone:716-625-9851
Mailing Address - Fax:716-625-9858
Practice Address - Street 1:6101 ROBINSON RD
Practice Address - Street 2:
Practice Address - City:LOCKPORT
Practice Address - State:NY
Practice Address - Zip Code:14094-8920
Practice Address - Country:US
Practice Address - Phone:716-625-9851
Practice Address - Fax:716-625-9858
Is Sole Proprietor?:No
Enumeration Date:2006-09-03
Last Update Date:2012-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3349331163W00000X
NYF300213-1363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse