Provider Demographics
NPI:1619937323
Name:CARDI, TODD (PT)
Entity Type:Individual
Prefix:
First Name:TODD
Middle Name:
Last Name:CARDI
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5795 WIDEWATERS PKWY
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13214-1832
Mailing Address - Country:US
Mailing Address - Phone:315-200-1800
Mailing Address - Fax:315-200-1800
Practice Address - Street 1:5795 WIDEWATERS PKWY
Practice Address - Street 2:SUITE 1A
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13214-1832
Practice Address - Country:US
Practice Address - Phone:315-200-1800
Practice Address - Fax:315-200-1800
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-25
Last Update Date:2013-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021825225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP26601Medicare UPIN
NYRA0041Medicare PIN
NYRA0040Medicare PIN