Provider Demographics
NPI:1942916028
Name:CARDOZA, ADAM VICTOR
Entity Type:Individual
Prefix:MR
First Name:ADAM
Middle Name:VICTOR
Last Name:CARDOZA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2365 21ST ST
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11105-3714
Mailing Address - Country:US
Mailing Address - Phone:347-249-6416
Mailing Address - Fax:
Practice Address - Street 1:2365 21ST ST
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11105-3714
Practice Address - Country:US
Practice Address - Phone:347-249-6416
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-23
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist