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Provider Information for 1225216880


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NICOLA GIORDANO Psy.D


Sex: Male

NPI: 1225216880
Last Updated: 2024-12-09
Certification Date: 2024-12-09

Details

NameValue
NPI1225216880
Enumeration Date2008-02-06
NPI TypeNPI-1 Individual
Sole ProprietorYES
StatusActive
Mailing Address 33 ANTHONY CT
BETHANY, CT 06524-3226
United States

Phone: 802-683-1540 | Fax:
 
Primary Practice Address 3074 WHITNEY AVENUE, BUILDING 1
HAMDEN, CT 06518-2324
United States

Phone: 203-936-8697 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
MEDICAIDCT1225216880
Other (non-Medicare)CT446545MHN
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
No 103TC0700X - Psychologist - ClinicalVT048-0000915
Yes 103TC0700X - Psychologist - ClinicalCT002904