Provider Demographics
NPI:1902006331
Name:MICHAEL J. CARDAMONE D.C., P.C.
Entity Type:Organization
Organization Name:MICHAEL J. CARDAMONE D.C., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:CARDAMONE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:716-278-5021
Mailing Address - Street 1:1221 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NIAGARA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14301-1115
Mailing Address - Country:US
Mailing Address - Phone:716-278-5021
Mailing Address - Fax:716-278-5022
Practice Address - Street 1:1221 MAIN ST
Practice Address - Street 2:
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14301-1115
Practice Address - Country:US
Practice Address - Phone:716-278-5021
Practice Address - Fax:716-278-5022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-24
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX010488-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYBA0752Medicare PIN