Healthcare Provider Details

I. General information

NPI: 1689896573
Provider Name (Legal Business Name): GINA R GIORDANO MS CCC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2007
Last Update Date: 01/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1920 CHESTNUT ST 200
PHILADELPHIA PA
19103
US

IV. Provider business mailing address

1920 CHESTNUT ST 200
PHILADELPHIA PA
19103
US

V. Phone/Fax

Practice location:
  • Phone: 215-561-0550
  • Fax: 215-561-1235
Mailing address:
  • Phone: 215-561-0550
  • Fax: 215-561-1235

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAT005775
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number41YA00060800
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number25MG00101600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: