Provider Demographics
NPI:1669485413
Name:CARDIEL, MYRNA IVONNE (MD)
Entity Type:Individual
Prefix:DR
First Name:MYRNA
Middle Name:IVONNE
Last Name:CARDIEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MYRNA
Other - Middle Name:IVONNE
Other - Last Name:DIAZ-ORTIZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:425 WASHINGTON BLVD
Mailing Address - Street 2:APARTMENT #2401
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07310-2019
Mailing Address - Country:US
Mailing Address - Phone:512-497-2979
Mailing Address - Fax:
Practice Address - Street 1:650 1ST AVE
Practice Address - Street 2:FOURTH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-3240
Practice Address - Country:US
Practice Address - Phone:512-497-2979
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY243308-12084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology