Provider Demographics
NPI:1851270961
Name:GIORDANO, NICOLE (LICENSE ESTHETICIAN)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:GIORDANO
Suffix:
Gender:F
Credentials:LICENSE ESTHETICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 S FRANKLIN ST UNIT 121
Mailing Address - Street 2:
Mailing Address - City:NYACK
Mailing Address - State:NY
Mailing Address - Zip Code:10960-3782
Mailing Address - Country:US
Mailing Address - Phone:845-405-5009
Mailing Address - Fax:
Practice Address - Street 1:77 S FRANKLIN ST UNIT 121
Practice Address - Street 2:
Practice Address - City:NYACK
Practice Address - State:NY
Practice Address - Zip Code:10960-3782
Practice Address - Country:US
Practice Address - Phone:845-405-5009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-02
Last Update Date:2025-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
374U00000X
NYAEE-14-05315207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No374U00000XNursing Service Related ProvidersHome Health Aide