Healthcare Provider Details

I. General information

NPI: 1669651162
Provider Name (Legal Business Name): JAMES K. CARDI,M.D.,INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2007
Last Update Date: 09/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

677 ATWOOD AVE
CRANSTON RI
02920-5322
US

IV. Provider business mailing address

677 ATWOOD AVE
CRANSTON RI
02920-5322
US

V. Phone/Fax

Practice location:
  • Phone: 401-942-6500
  • Fax: 401-942-6505
Mailing address:
  • Phone: 401-942-6500
  • Fax: 401-942-6505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License NumberMD8000
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD08000
License Number StateRI

VIII. Authorized Official

Name: MR. JAMES K CARDI
Title or Position: PRESIDENT
Credential: M.D.
Phone: 401-942-6500