Provider Demographics
NPI:1902975998
Name:GIORDANO, PAUL JOSEPH (ND, LDN)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:JOSEPH
Last Name:GIORDANO
Suffix:
Gender:M
Credentials:ND, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:143 SEMINOLE AVE
Mailing Address - Street 2:
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02451-0858
Mailing Address - Country:US
Mailing Address - Phone:508-878-2415
Mailing Address - Fax:
Practice Address - Street 1:225 BROADWAY
Practice Address - Street 2:SUITE 209
Practice Address - City:METHUEN
Practice Address - State:MA
Practice Address - Zip Code:01844-3003
Practice Address - Country:US
Practice Address - Phone:978-688-7100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2011-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1597133N00000X
WANT00000698175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No133N00000XDietary & Nutritional Service ProvidersNutritionist