MEDICARE: MS. TERESA GIORDANO CRNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0200X	Pediatric Nurse Practitioner	TP004147N	PA

General Provider Information

NPI Number	:	1154318160
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TERESA GIORDANO CRNP

Provider Business Mailing Address
First Line	:	3500 CIVIC CENTER BLVD
Second Line	:	5TH FLOOR HUB, DIVISION OF OTOLARYNGOLOGY
City	:	PHILADELPHIA
State	:	PA
Zip	:	19104-4306
Country	:	US
Telephone Number	:	215-590-3440
Fax Number	:	215-590-3986

Provider Business Practice Location Address
First Line	:	3400 CIVIC CENTER BLVD
Second Line	:	1ST FLOOR WOOD BLDG DEPARTMENT OF OTOLARYNGOLOGY
City	:	PHILADELPHIA
State	:	PA
Zip	:	19104-4306
Country	:	US
Telephone Number	:	215-590-3440
Fax Number	:	215-590-3986

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/04/2005
Last Update Date	:	01/12/2023

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