Provider Demographics
NPI:1083989073
Name:ROBERT C. CIARDULLO, MD
Entity Type:Organization
Organization Name:ROBERT C. CIARDULLO, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:C
Authorized Official - Last Name:CIARDULLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-948-4636
Mailing Address - Street 1:170 MAPLE AVE.
Mailing Address - Street 2:SUITE 305
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601-4714
Mailing Address - Country:US
Mailing Address - Phone:914-948-4636
Mailing Address - Fax:914-328-8628
Practice Address - Street 1:170 MAPLE AVE.
Practice Address - Street 2:SUITE 305
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-4714
Practice Address - Country:US
Practice Address - Phone:914-948-4636
Practice Address - Fax:914-328-8628
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-09
Last Update Date:2012-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty