Provider Demographics
NPI:1902986896
Name:GIORDANO, RICHARD S (DPM)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:S
Last Name:GIORDANO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:DR
Other - First Name:RICHARD
Other - Middle Name:S
Other - Last Name:GIORDANO
Other - Suffix:I
Other - Last Name Type:Professional Name
Other - Credentials:DPM
Mailing Address - Street 1:101 KENSINGTON WAY
Mailing Address - Street 2:
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-2506
Mailing Address - Country:US
Mailing Address - Phone:914-241-6326
Mailing Address - Fax:
Practice Address - Street 1:344 E MAIN ST
Practice Address - Street 2:206
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-3027
Practice Address - Country:US
Practice Address - Phone:914-241-3332
Practice Address - Fax:914-241-4551
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002210213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00416459Medicaid
NY00416459Medicaid
NYP2387Medicare ID - Type Unspecified