Healthcare Provider Details

I. General information

NPI: 1225223837
Provider Name (Legal Business Name): PETER GIORDANO L.AC, LMT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/07/2007
Last Update Date: 03/26/2024
Certification Date: 03/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 W 19TH ST STE 1103
NEW YORK NY
10011-4128
US

IV. Provider business mailing address

151 W 19TH ST STE 1103
NEW YORK NY
10011-4128
US

V. Phone/Fax

Practice location:
  • Phone: 631-905-6870
  • Fax:
Mailing address:
  • Phone: 631-905-6870
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number020301
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number004995
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: