Provider Demographics
NPI:1639410673
Name:GIORDANO, ROBERT (LAC)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:GIORDANO
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 UNION SQ E
Mailing Address - Street 2:SUITE 411 @ WELLSPACE
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-3209
Mailing Address - Country:US
Mailing Address - Phone:646-470-6709
Mailing Address - Fax:
Practice Address - Street 1:32 UNION SQ E
Practice Address - Street 2:SUITE 411 @WELLSPACE
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-3209
Practice Address - Country:US
Practice Address - Phone:646-470-6709
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-14
Last Update Date:2013-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002309171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist