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General NPI Number Information
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NPI Number | 1649455973
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Entity Type | Organization
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Legal Business Name | ROBERT J. GIORDANO MD PC
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Dates
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Enumeration Date | 01/06/2008
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Last Update Date | 01/06/2008
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Provider Practice Location Address
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Address Line | 100 SOUTH ST STE 205
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City | SOUTHBRIDGE
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State | MA
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Zip | 01550-4051
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Country | US
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Telephone | 508-765-0934
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Fax |
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Provider Business Mailing Address
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Address Line | 100 SOUTH ST STE 205
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City | SOUTHBRIDGE
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State | MA
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Zip | 01550-4051
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Country | US
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Telephone | 508-765-0934
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. ROBERT JOSEPH GIORDANO
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Credential | MD
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Telephone | 508-765-0934
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080A0000X
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Taxonomy Name | Pediatric Adolescent Medicine Physician
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License Number | 59625
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License Number State | MA
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