Provider Demographics
NPI:1952466021
Name:JOSEPH P. CARDINALE, D.O., P.C.
Entity Type:Organization
Organization Name:JOSEPH P. CARDINALE, D.O., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:FRAZIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-838-6462
Mailing Address - Street 1:879 S ARLINGTON AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17109-5004
Mailing Address - Country:US
Mailing Address - Phone:717-657-1424
Mailing Address - Fax:717-657-8887
Practice Address - Street 1:879 S ARLINGTON AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17109-5004
Practice Address - Country:US
Practice Address - Phone:717-657-1424
Practice Address - Fax:717-657-8887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS003804L208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0006398210001Medicaid
PA510370Medicare ID - Type Unspecified
PAB37356Medicare UPIN