Provider Demographics
NPI:1245698703
Name:GIARDINI, ELISABETH
Entity type:Individual
Prefix:MS
First Name:ELISABETH
Middle Name:
Last Name:GIARDINI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79 FOSTER AVE
Mailing Address - Street 2:
Mailing Address - City:SAYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11782-3127
Mailing Address - Country:US
Mailing Address - Phone:516-607-9196
Mailing Address - Fax:
Practice Address - Street 1:1909 22ND DR
Practice Address - Street 2:APT 2
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11105-3701
Practice Address - Country:US
Practice Address - Phone:516-607-9196
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-29
Last Update Date:2016-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program