Provider Demographics
NPI:1831289529
Name:CARDONICK, ELYCE H (MD)
Entity Type:Individual
Prefix:
First Name:ELYCE
Middle Name:H
Last Name:CARDONICK
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 1:3 COOPER PLZ
Mailing Address - Street 2:SUITE 502
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1438
Mailing Address - Country:US
Mailing Address - Phone:856-968-7433
Mailing Address - Fax:
Practice Address - Street 1:1 COOPER PLZ
Practice Address - Street 2:DORRANCE BUILDING, ROOM 623
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103-1461
Practice Address - Country:US
Practice Address - Phone:856-324-2491
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2016-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA65877207VM0101X
PAMD054968L207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3341708OtherAETNA
NJ60004492OtherHORIZON NJ HEALTH
NJ60005429OtherHORIZON NJ HEALTH
NJ0423103000OtherAMERIHEALTH/KEYSTONE/IBC
NJ8134104OtherCIGNA
NJ010005628OtherAMERICHOICE
NJ656684OtherAMERIHEALTH PPO/PA BS
NJ7407904Medicaid
NJ24704OtherUNIVERSITY HEALTH PLAN
NJP3081743OtherOXFORD
NJ1963862OtherUNITED HEALTHCARE
NJ3341704OtherAETNA
NJ60004492OtherHORIZON NJ HEALTH
NJ7407904Medicaid