Healthcare Provider Details

I. General information

NPI: 1043224520
Provider Name (Legal Business Name): DENNIS A CARDONE D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 04/14/2022
Certification Date: 04/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 1ST AVE SUITE 8U
NEW YORK NY
10016-6402
US

IV. Provider business mailing address

530 1ST AVE SUITE 8U
NEW YORK NY
10016-6402
US

V. Phone/Fax

Practice location:
  • Phone: 212-263-9192
  • Fax: 212-263-9701
Mailing address:
  • Phone: 212-263-9192
  • Fax: 212-263-9701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License NumberOS737
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number197292
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: