Provider Demographics
NPI:1235138728
Name:CARDENAS, DORA L (MD)
Entity Type:Individual
Prefix:DR
First Name:DORA
Middle Name:L
Last Name:CARDENAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 CENTRAL PARK W
Mailing Address - Street 2:SUITE 1C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-4530
Mailing Address - Country:US
Mailing Address - Phone:212-724-7401
Mailing Address - Fax:212-724-7401
Practice Address - Street 1:241 CENTRAL PARK W
Practice Address - Street 2:SUITE 1C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-4530
Practice Address - Country:US
Practice Address - Phone:212-724-7401
Practice Address - Fax:212-724-7401
Is Sole Proprietor?:No
Enumeration Date:2005-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1803552084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP842350OtherOXFORD HEALTH PLANS
NYP842350OtherOXFORD HEALTH PLANS