Provider Demographics
NPI:1659661882
Name:CARDOZO, ZINA-ANN
Entity Type:Individual
Prefix:DR
First Name:ZINA-ANN
Middle Name:
Last Name:CARDOZO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2305 ADAMS AVE
Mailing Address - Street 2:APARTMENT #9
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25704-1352
Mailing Address - Country:US
Mailing Address - Phone:304-710-9272
Mailing Address - Fax:
Practice Address - Street 1:4749 ROUTE 152
Practice Address - Street 2:
Practice Address - City:LAVALETTE
Practice Address - State:WV
Practice Address - Zip Code:25535-9638
Practice Address - Country:US
Practice Address - Phone:304-525-3992
Practice Address - Fax:304-525-4693
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-08
Last Update Date:2011-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0007366183500000X
AZS017798183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist