Provider Demographics
NPI:1841813912
Name:GIORDANO, RACHELANN
Entity type:Individual
Prefix:
First Name:RACHELANN
Middle Name:
Last Name:GIORDANO
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 1:307 8TH AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:ASBURY PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07712-5286
Mailing Address - Country:US
Mailing Address - Phone:908-451-4155
Mailing Address - Fax:
Practice Address - Street 1:99 ROUTE 37 W
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-6423
Practice Address - Country:US
Practice Address - Phone:732-557-8000
Practice Address - Fax:732-923-2272
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-25
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00572600363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant