MEDICARE: DR. DOMINICK A GIORDANO DMD

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	122300000X	Dentist	039718-1	NY

General Provider Information

NPI Number	:	1831418854
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DOMINICK A GIORDANO DMD

Provider Business Mailing Address
First Line	:	367 W 49TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10019-7316
Country	:	US
Telephone Number	:	212-367-7120
Fax Number	:	917-470-9562

Provider Business Practice Location Address
First Line	:	367 W 49TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10019-7316
Country	:	US
Telephone Number	:	212-367-7120
Fax Number	:	917-470-9562

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

Provider Enumeration Date	:	06/01/2010
Last Update Date	:	06/01/2010

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