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NPI Code Detail

MEDICARE: GERALDINE A CADLAON

MEDICARE: GERALDINE A CADLAON
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
1133N00000XNutritionist

General Provider Information

NPI Number : 1720355738
Entity Type Code : Individual
Provider Name (Legal Business Name) : GERALDINE A CADLAON
Provider Business Mailing Address
First Line : 2079 FOREST AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10303-1735
Country : US
Telephone Number : 718-815-6560
Fax Number : 718-815-6570
Provider Business Practice Location Address
First Line : 2079 FOREST AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10303-1735
Country : US
Telephone Number : 718-815-6560
Fax Number : 718-815-6570
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/18/2011
Last Update Date : 11/18/2011

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Directions to “ GERALDINE A CADLAON ” Practice Location

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