Provider Demographics
NPI:1376739995
Name:CARDELLO, JOHN FRANK JR (RD)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:FRANK
Last Name:CARDELLO
Suffix:JR
Gender:M
Credentials:RD
Other - Prefix:
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Mailing Address - Street 1:84 MATTIX RUN
Mailing Address - Street 2:
Mailing Address - City:GALLOWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08205-3508
Mailing Address - Country:US
Mailing Address - Phone:609-748-0761
Mailing Address - Fax:609-748-0761
Practice Address - Street 1:1301 ROUTE 72 W STE 300
Practice Address - Street 2:
Practice Address - City:MANAHAWKIN
Practice Address - State:NJ
Practice Address - Zip Code:08050-2483
Practice Address - Country:US
Practice Address - Phone:609-597-6513
Practice Address - Fax:609-597-2055
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-18
Last Update Date:2009-11-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered