Provider Demographics
NPI:1043224520
Name:CARDONE, DENNIS A (DO)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:A
Last Name:CARDONE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 1ST AVE
Mailing Address - Street 2:SUITE 8U
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-6402
Mailing Address - Country:US
Mailing Address - Phone:212-263-9192
Mailing Address - Fax:212-263-9701
Practice Address - Street 1:530 1ST AVE
Practice Address - Street 2:SUITE 8U
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6402
Practice Address - Country:US
Practice Address - Phone:212-263-9192
Practice Address - Fax:212-263-9701
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS737207QS0010X
NY197292207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL37115OtherBLUE CROSS BLUE SHIELD
FL37115OtherBLUE CROSS BLUE SHIELD
513978Medicare ID - Type Unspecified