Provider Demographics
NPI:1295927077
Name:GIARDINA & GLUBO DPM PA
Entity type:Organization
Organization Name:GIARDINA & GLUBO DPM PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VITO
Authorized Official - Middle Name:NICHOLAS
Authorized Official - Last Name:GIARDINA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:410-747-6655
Mailing Address - Street 1:700 GEIPE RD
Mailing Address - Street 2:SUITE 260
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-4147
Mailing Address - Country:US
Mailing Address - Phone:410-747-6655
Mailing Address - Fax:410-744-0378
Practice Address - Street 1:700 GEIPE RD
Practice Address - Street 2:SUITE 260
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21228-4147
Practice Address - Country:US
Practice Address - Phone:410-747-6655
Practice Address - Fax:410-744-0378
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-15
Last Update Date:2019-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD983798101Medicaid
MDK924Medicare PIN
CB1428Medicare PIN