Provider Demographics
NPI:1376569269
Name:SCARDINA, ERIC CHARLES (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:CHARLES
Last Name:SCARDINA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:161 MADISON AVE
Mailing Address - Street 2:SUITE 9NE
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-5421
Mailing Address - Country:US
Mailing Address - Phone:212-685-0594
Mailing Address - Fax:212-685-0694
Practice Address - Street 1:161 MADISON AVE
Practice Address - Street 2:SUITE 9NE
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-5421
Practice Address - Country:US
Practice Address - Phone:212-685-0594
Practice Address - Fax:212-685-0694
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2011-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY186816207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN87323OtherHEALTHNET PROVIDER #
NYP3180297OtherOXFORD PROVIDER #
NY6017793OtherGHI PROVIDER #
NYF60141Medicare UPIN
NY21N901Medicare PIN