Provider Demographics
NPI:1649421686
Name:CARDI, CESARE JR
Entity Type:Individual
Prefix:
First Name:CESARE
Middle Name:
Last Name:CARDI
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:517 TREE LINE DR
Mailing Address - Street 2:
Mailing Address - City:GIBSONIA
Mailing Address - State:PA
Mailing Address - Zip Code:15044-6199
Mailing Address - Country:US
Mailing Address - Phone:724-831-3302
Mailing Address - Fax:
Practice Address - Street 1:9201 E MOUNTAIN VIEW RD
Practice Address - Street 2:SUITE 220
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-5199
Practice Address - Country:US
Practice Address - Phone:480-862-1700
Practice Address - Fax:877-561-7566
Is Sole Proprietor?:No
Enumeration Date:2008-10-08
Last Update Date:2019-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP009930363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA136629XRNMedicare PIN