Healthcare Provider Details

I. General information

NPI: 1265250914
Provider Name (Legal Business Name): SANDY MARIE GIORDANO LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2024
Last Update Date: 10/01/2024
Certification Date: 10/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

607 N JEROME AVE
MARGATE CITY NJ
08402-1527
US

IV. Provider business mailing address

139 WALKER AVE
WOODBURY NJ
08096-5584
US

V. Phone/Fax

Practice location:
  • Phone: 609-822-1108
  • Fax:
Mailing address:
  • Phone: 856-938-8513
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number44SL07200500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: