Provider Demographics
NPI:1639274897
Name:RALPH A CARDAMONE MD PC
Entity Type:Organization
Organization Name:RALPH A CARDAMONE MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:A
Authorized Official - Last Name:CARDAMONE
Authorized Official - Suffix:
Authorized Official - Credentials:MD PC
Authorized Official - Phone:814-339-7101
Mailing Address - Street 1:PO BOX 167
Mailing Address - Street 2:
Mailing Address - City:CLEARFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:16830-0167
Mailing Address - Country:US
Mailing Address - Phone:814-339-7101
Mailing Address - Fax:814-339-6165
Practice Address - Street 1:10 S 2ND ST
Practice Address - Street 2:
Practice Address - City:CLEARFIELD
Practice Address - State:PA
Practice Address - Zip Code:16830-2347
Practice Address - Country:US
Practice Address - Phone:814-339-7101
Practice Address - Fax:814-339-6165
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2007-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PACD5058OtherRAILROAD MEDICARE
PA0015988400006Medicaid
PA881422Medicare PIN