Healthcare Provider Details

I. General information

NPI: 1285707356
Provider Name (Legal Business Name): VITO R CARDONE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/16/2006
Last Update Date: 02/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 MAIN ST SUITE 150
STONEHAM MA
02180-3335
US

IV. Provider business mailing address

2 MAIN ST SUITE 150
STONEHAM MA
02180-3335
US

V. Phone/Fax

Practice location:
  • Phone: 781-438-9600
  • Fax: 781-438-9601
Mailing address:
  • Phone: 781-438-9600
  • Fax: 781-438-9601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number56751
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: