MEDICARE: ADRIANA GIRARD PA-C

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	363A00000X	Physician Assistant
2	363A00000X	Physician Assistant	25MP00708500	NJ

General Provider Information

NPI Number	:	1982326617
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADRIANA GIRARD PA-C

Provider Business Mailing Address
First Line	:	31 BUTTERNUTT CT
Second Line	:
City	:	OAKLAND
State	:	NJ
Zip	:	07436-1814
Country	:	US
Telephone Number	:	201-819-2509
Fax Number	:

Provider Business Practice Location Address
First Line	:	71 UNION AVE STE 108
Second Line	:
City	:	RUTHERFORD
State	:	NJ
Zip	:	07070-1272
Country	:	US
Telephone Number	:	201-804-8900
Fax Number	:

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

Provider Enumeration Date	:	09/19/2022
Last Update Date	:	09/19/2022

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Directions to “ ADRIANA GIRARD PA-C” Practice Location

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