Healthcare Provider Details

I. General information

NPI: 1194372151
Provider Name (Legal Business Name): CARDINAL PEDIATRICS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2019
Last Update Date: 06/24/2025
Certification Date: 06/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 VARNUM AVE STE 204
LOWELL MA
01854-2109
US

IV. Provider business mailing address

275 VARNUM AVE STE 204
LOWELL MA
01854-2109
US

V. Phone/Fax

Practice location:
  • Phone: 978-452-1666
  • Fax: 978-452-1780
Mailing address:
  • Phone: 978-452-1666
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: ELLYN ARIAS
Title or Position: PRACTICE MANAGER
Credential:
Phone: 978-902-3307