Provider Demographics
NPI:1184785123
Name:RONALD GIARDELLI MD PC
Entity type:Organization
Organization Name:RONALD GIARDELLI MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD PC PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:GIARDELLI
Authorized Official - Suffix:
Authorized Official - Credentials:MD PC
Authorized Official - Phone:516-747-3211
Mailing Address - Street 1:520 FRANKLIN AVENUE
Mailing Address - Street 2:SUITE 120
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-5814
Mailing Address - Country:US
Mailing Address - Phone:516-747-3211
Mailing Address - Fax:516-873-0330
Practice Address - Street 1:520 FRANKLIN AVENUE
Practice Address - Street 2:SUITE 120
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-5814
Practice Address - Country:US
Practice Address - Phone:516-747-3211
Practice Address - Fax:516-873-0330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2010-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
033ANOtherBCBC
2594729OtherOXFORD
033ANOtherBCBC