Provider Demographics
NPI:1669812731
Name:CARDUCCI, DANIEL (PA)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:CARDUCCI
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 WALTER E FORAN BLVD STE 4000
Mailing Address - Street 2:
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-4675
Mailing Address - Country:US
Mailing Address - Phone:908-824-7179
Mailing Address - Fax:908-824-7684
Practice Address - Street 1:5 WALTER E FORAN BLVD STE 4000
Practice Address - Street 2:
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-4675
Practice Address - Country:US
Practice Address - Phone:908-824-7179
Practice Address - Fax:908-824-7684
Is Sole Proprietor?:No
Enumeration Date:2013-07-03
Last Update Date:2014-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00308700363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical