MEDICARE: BRIANNA NICOLE CARDACI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1497527469
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIANNA NICOLE CARDACI

Provider Business Mailing Address
First Line	:	132 WINSTON DR
Second Line	:
City	:	MATAWAN
State	:	NJ
Zip	:	07747-9720
Country	:	US
Telephone Number	:	732-320-0927
Fax Number	:

Provider Business Practice Location Address
First Line	:	436 CHESTNUT ST
Second Line	:
City	:	LAKEWOOD
State	:	NJ
Zip	:	08701-5811
Country	:	US
Telephone Number	:	866-959-2846
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/24/2023
Last Update Date	:	10/24/2023

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Directions to “ BRIANNA NICOLE CARDACI ” Practice Location

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