Provider Demographics
NPI:1750866083
Name:GIARDINA, TERRI (LPN)
Entity Type:Individual
Prefix:
First Name:TERRI
Middle Name:
Last Name:GIARDINA
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:678 MAIN ST APT B
Mailing Address - Street 2:
Mailing Address - City:WHITESVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14897-9705
Mailing Address - Country:US
Mailing Address - Phone:585-596-9389
Mailing Address - Fax:
Practice Address - Street 1:678 MAIN ST APT B
Practice Address - Street 2:
Practice Address - City:WHITESVILLE
Practice Address - State:NY
Practice Address - Zip Code:14897-9705
Practice Address - Country:US
Practice Address - Phone:607-356-3122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-02
Last Update Date:2018-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY9542261164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse