Organization Active NPI

Anthony L Giordano,PH.D. LLC

  • Clinical Psychologist
  • Cherry Hill, NJ
National Provider Identifier
1316206147
Registry record updated May 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
35SI00342800 Issued in NJ
Legal business name
ANTHONY L GIORDANO,PH.D. LLC
Practice address
300 Marlton Pike W
Suite 107
Cherry Hill, NJ 08002-3053
Phone
(856) 429-1444
Fax
(856) 429-1440
NPI assigned
May 14, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Anthony L Giordano, PH.D.NPI 1669543898
Title
President
Phone
(856) 429-1444

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 35SI00342800 NJ Primary

Addresses

Primary practice location

300 Marlton Pike W
Suite 107
Cherry Hill, NJ 08002-3053

Mailing address

300 Marlton Pike W
Suite 107
Cherry Hill, NJ 08002-3053
Phone (856) 429-1444

Other identifiers 1

IdentifierTypeStateIssuer
7805501MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120625000271 NJ Part B Supplier - Clinic/Group Practice 5991960973 Receives reassigned benefits from 1 practitioner
Practice locations: Cherry Hill, NJ

National Provider Directory

National Provider Directory

Locations

811 Church Rd
Ste 160
Cherry Hill, NJ 08002
Phone (856) 488-8080

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1336953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336953600000",
    "number": "1316206147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 MARLTON PIKE W",
            "address_2": "SUITE 107",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080023053",
            "telephone_number": "856-429-1444",
            "fax_number": "856-429-1440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MARLTON PIKE W",
            "address_2": "SUITE 107",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080023053",
            "telephone_number": "856-429-1444",
            "fax_number": "856-429-1440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTHONY L GIORDANO,PH.D. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-14",
        "last_updated": "2012-05-14",
        "status": "A",
        "authorized_official_last_name": "GIORDANO",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "856-429-1444",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "35SI00342800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7805501",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherry Hill, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.