1861549867 NPI number — LAWRENCE S. GIORDANO, DDS, PA

Table of content: (NPI 1861549867)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861549867 NPI number — LAWRENCE S. GIORDANO, DDS, PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LAWRENCE S. GIORDANO, DDS, PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1861549867
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/04/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1601 MILLTOWN RD
Provider Second Line Business Mailing Address:
SUITE 17
Provider Business Mailing Address City Name:
WILMINGTON
Provider Business Mailing Address State Name:
DE
Provider Business Mailing Address Postal Code:
19808-4027
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
302-995-1870
Provider Business Mailing Address Fax Number:
302-995-9568

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1601 MILLTOWN RD
Provider Second Line Business Practice Location Address:
SUITE 17
Provider Business Practice Location Address City Name:
WILMINGTON
Provider Business Practice Location Address State Name:
DE
Provider Business Practice Location Address Postal Code:
19808-4027
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
302-995-1870
Provider Business Practice Location Address Fax Number:
302-995-9568
Provider Enumeration Date:
01/04/2007

Additional Information

Authorized Official

Authorized Official Last Name:
SUBACH
Authorized Official First Name:
PETER
Authorized Official Middle Name:
F
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
302-995-1870

Provider Taxonomy Codes

  • Taxonomy code: 1223S0112X , with the licence number:  G10001087 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com