Provider Demographics
NPI:1386637924
Name:CARDONE, JOHN T (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:T
Last Name:CARDONE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:19 WOODLAND ST
Mailing Address - Street 2:STE 47
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06105-2372
Mailing Address - Country:US
Mailing Address - Phone:860-525-4005
Mailing Address - Fax:860-525-4839
Practice Address - Street 1:19 WOODLAND ST
Practice Address - Street 2:STE 35
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06105-2372
Practice Address - Country:US
Practice Address - Phone:860-525-1234
Practice Address - Fax:860-278-8782
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT026273207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
00126273204OtherANTHEM BLUE CROSS
CTHAS597OtherOXFORD
CTOV4105OtherHEALTH NET
2083439OtherAETNA
0004288570OtherAETNA
01002673CT01OtherANTHEM BLUE CROSS
CT727453OtherCONNECTICARE
CTOV4105OtherHEALTH NET