Healthcare Provider Details

I. General information

NPI: 1194750638
Provider Name (Legal Business Name): PATRICIA JANE GIARDINA C.N.M.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 11/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 NORTH ST
PITTSFIELD MA
01201-4147
US

IV. Provider business mailing address

740 WILLIAMS ST
PITTSFIELD MA
01201-7463
US

V. Phone/Fax

Practice location:
  • Phone: 413-499-8570
  • Fax: 413-499-8565
Mailing address:
  • Phone: 413-442-2226
  • Fax: 413-442-1314

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number176495
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: