Provider Demographics
NPI:1346462256
Name:CARDONA, MICHELLE (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:
Last Name:CARDONA
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06457-3649
Mailing Address - Country:US
Mailing Address - Phone:860-358-6300
Mailing Address - Fax:860-358-6650
Practice Address - Street 1:90 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:CT
Practice Address - Zip Code:06457-3649
Practice Address - Country:US
Practice Address - Phone:860-358-6300
Practice Address - Fax:860-358-6650
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2014-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT52368207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine