Healthcare Provider Details

I. General information

NPI: 1568579001
Provider Name (Legal Business Name): JOSEPH DENNIS GIARDINA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/23/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

898 OYSTER BAY RD SUITE D
EAST NORWICH NY
11732-1051
US

IV. Provider business mailing address

898 OYSTER BAY RD SUITE D
EAST NORWICH NY
11732-1051
US

V. Phone/Fax

Practice location:
  • Phone: 516-922-1252
  • Fax: 516-922-1254
Mailing address:
  • Phone: 516-922-1252
  • Fax: 516-922-1254

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number156089-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: