Provider Demographics
NPI:1821180662
Name:CARDENAS, GLADYS (MD)
Entity Type:Individual
Prefix:DR
First Name:GLADYS
Middle Name:
Last Name:CARDENAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1207 ROUTE 9 STE 12
Mailing Address - Street 2:
Mailing Address - City:WAPPINGERS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12590-4987
Mailing Address - Country:US
Mailing Address - Phone:845-297-3200
Mailing Address - Fax:845-297-7891
Practice Address - Street 1:1207 ROUTE 9 STE 12
Practice Address - Street 2:
Practice Address - City:WAPPINGERS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12590-4987
Practice Address - Country:US
Practice Address - Phone:845-297-3200
Practice Address - Fax:845-297-7891
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2019-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY189011208VP0014X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY76K832Medicare ID - Type Unspecified
NYF35461Medicare UPIN