Healthcare Provider Details

I. General information

NPI: 1932191376
Provider Name (Legal Business Name): JOSEPH G CARDINALE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2005
Last Update Date: 09/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 YORK ST SMILOW CANCER HOSPITAL AT YNHH
NEW HAVEN CT
06510-3220
US

IV. Provider business mailing address

300 GEORGE ST 6TH FLOOR
NEW HAVEN CT
06511-6624
US

V. Phone/Fax

Practice location:
  • Phone: 203-200-2100
  • Fax: 203-200-2180
Mailing address:
  • Phone: 203-785-4216
  • Fax: 203-200-2180

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0203X
TaxonomyTherapeutic Radiology Physician
License Number024313
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: