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General NPI Number Information
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NPI Number | 1790811578
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Entity Type | Individual
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Provider Name | MARK CARDIS
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Gender | Male
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 118 FARNSWORTH AVE
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City | BORDENTOWN
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State | NJ
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Zip | 08505-1308
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Country | US
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Telephone | 609-298-1811
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Fax |
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Provider Business Mailing Address
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Address Line | 218 W FEDERAL ST
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City | BURLINGTON
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State | NJ
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Zip | 08016-1429
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Country | US
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Telephone | 609-386-8956
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number |
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License Number State | NJ
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