Alexander Giordano, OTR/L

Individual provider Active NPI Occupational Therapist · Godfrey, IL

NPI 1790287035 · NPPES record last updated Mar 2, 2018

Key facts

NPI
1790287035
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
056012406 (IL)
Practice address
812 Airport Rd
Godfrey, IL 62035-2920
Phone
(618) 466-2134
NPI assigned
Mar 2, 2018
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
056012406ILMDOccupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 056012406 IL Yes

Addresses

Primary practice location

812 Airport Rd
Godfrey, IL 62035-2920

Mailing address

812 Airport Rd
Godfrey, IL 62035-2920

Other providers in Godfrey, IL

All providers in Godfrey, IL · Occupational Therapist in Illinois

Sources for this page

Verify at the official NPI Registry.