Healthcare Provider Details

I. General information

NPI: 1902975998
Provider Name (Legal Business Name): PAUL JOSEPH GIORDANO N.D., L.D.N.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 06/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 BROADWAY SUITE 209
METHUEN MA
01844-3003
US

IV. Provider business mailing address

143 SEMINOLE AVE
WALTHAM MA
02451-0858
US

V. Phone/Fax

Practice location:
  • Phone: 978-688-7100
  • Fax:
Mailing address:
  • Phone: 508-878-2415
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number1597
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberNT00000698
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: