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General NPI Number Information
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NPI Number | 1295554533
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Entity Type | Individual
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Provider Name | CARDINE HARRIS
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Gender | Female
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Dates
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Enumeration Date | 10/03/2024
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Last Update Date | 10/03/2024
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Provider Practice Location Address
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Address Line | 1400 ROUTE 70
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City | LAKEWOOD
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State | NJ
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Zip | 08701-5949
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Country | US
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Telephone | 732-370-0444
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Fax |
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Provider Business Mailing Address
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Address Line | 160 JAMES ST BLDG 4-12
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City | TOMS RIVER
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State | NJ
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Zip | 08753-5571
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Country | US
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Telephone | 914-564-8550
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 26NP49590000
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License Number State | NJ
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