Healthcare Provider Details

I. General information

NPI: 1649421686
Provider Name (Legal Business Name): CESARE CARDI JR.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/08/2008
Last Update Date: 04/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9201 E MOUNTAIN VIEW RD SUITE 220
SCOTTSDALE AZ
85258-5199
US

IV. Provider business mailing address

517 TREE LINE DR
GIBSONIA PA
15044-6199
US

V. Phone/Fax

Practice location:
  • Phone: 480-862-1700
  • Fax: 877-561-7566
Mailing address:
  • Phone: 724-831-3302
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP009930
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: