Provider Demographics
NPI:1689831554
Name:GIARDINA, GARY M (RPA-C)
Entity Type:Individual
Prefix:MR
First Name:GARY
Middle Name:M
Last Name:GIARDINA
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Gender:M
Credentials:RPA-C
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Mailing Address - Street 1:2900 BEDFORD AVE
Mailing Address - Street 2:114 ROOSEVELT
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-2850
Mailing Address - Country:US
Mailing Address - Phone:718-951-5580
Mailing Address - Fax:718-951-5869
Practice Address - Street 1:2900 BEDFORD AVE
Practice Address - Street 2:114 ROOSEVELT
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11210-2850
Practice Address - Country:US
Practice Address - Phone:718-951-5580
Practice Address - Fax:718-951-5869
Is Sole Proprietor?:No
Enumeration Date:2008-05-19
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY004761363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant