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NPI Code Detail

MEDICARE: DR. MARNIE JOAN DARDANELLO MD

MEDICARE: DR. MARNIE JOAN DARDANELLO MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician25MA07717200NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1679545529
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARNIE JOAN DARDANELLO MD
Provider Business Mailing Address
First Line : 1 DIAMOND HILL RD
Second Line :
City : BERKELEY HEIGHTS
State : NJ
Zip : 07922-2104
Country : US
Telephone Number : 908-273-4300
Fax Number :
Provider Business Practice Location Address
First Line : 574 SPRINGFIELD AVE
Second Line :
City : WESTFIELD
State : NJ
Zip : 07090-1001
Country : US
Telephone Number : 908-603-8868
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2006
Last Update Date : 12/01/2020

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