Healthcare Provider Details

I. General information

NPI: 1952917379
Provider Name (Legal Business Name): DAWN A GIARDINA AGPCNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2020
Last Update Date: 03/15/2022
Certification Date: 03/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3332 WALDEN AVE
DEPEW NY
14043-2400
US

IV. Provider business mailing address

42 HAMILTON DR
BUFFALO NY
14226-4455
US

V. Phone/Fax

Practice location:
  • Phone: 716-668-7051
  • Fax: 716-558-0279
Mailing address:
  • Phone: 716-239-0471
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number309577
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number309577
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: