Provider Demographics
NPI:1689234536
Name:CARDONE, JESSICA F
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:F
Last Name:CARDONE
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 1:354 JOAN ST
Mailing Address - Street 2:
Mailing Address - City:RONKONKOMA
Mailing Address - State:NY
Mailing Address - Zip Code:11779-6211
Mailing Address - Country:US
Mailing Address - Phone:631-467-4375
Mailing Address - Fax:
Practice Address - Street 1:354 JOAN ST
Practice Address - Street 2:
Practice Address - City:RONKONKOMA
Practice Address - State:NY
Practice Address - Zip Code:11779-6211
Practice Address - Country:US
Practice Address - Phone:631-467-4375
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-13
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist