Provider Demographics
NPI:1679634414
Name:GIARDINA-BECKETT, MARIEANNE (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIEANNE
Middle Name:
Last Name:GIARDINA-BECKETT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 UNION AVE
Mailing Address - Street 2:SUITE108
Mailing Address - City:RUTHERFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07070-1274
Mailing Address - Country:US
Mailing Address - Phone:201-804-8900
Mailing Address - Fax:201-804-8901
Practice Address - Street 1:71 UNION AVE
Practice Address - Street 2:SUITE 108
Practice Address - City:RUTHERFORD
Practice Address - State:NJ
Practice Address - Zip Code:07070-1274
Practice Address - Country:US
Practice Address - Phone:201-804-8900
Practice Address - Fax:201-804-8901
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05578600207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ113559Medicare PIN
NEE68907Medicare UPIN