Basic Information
Provider Information
NPI: 1558330589
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GIORDANO
FirstName: MIRNA
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 8 E 92ND ST
Address2:  
City: NEW YORK
State: NY
PostalCode: 101280621
CountryCode: US
TelephoneNumber: 2124260607
FaxNumber:  
Practice Location
Address1: COLUMBIA UNVERSITY DEPARTMENT PEDIATRICS
Address2: 3959 BROADWAY
City: NEW YORK
State: NC
PostalCode: 10032
CountryCode: US
TelephoneNumber: 2123047250
FaxNumber: 2125441974
Other Information
ProviderEnumerationDate: 03/14/2006
LastUpdateDate: 04/24/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/24/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2080P0204X230341NYN Allopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine
208000000X230341NYY Allopathic & Osteopathic PhysiciansPediatrics 

No ID Information.


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