Provider Demographics
NPI:1013079094
Name:ERIC C. SCARDINA, M.D., P.C.
Entity type:Organization
Organization Name:ERIC C. SCARDINA, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:SCARDINA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-685-0594
Mailing Address - Street 1:161 MADISON AVE
Mailing Address - Street 2:SUITE 9NE
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-5421
Mailing Address - Country:US
Mailing Address - Phone:212-685-0594
Mailing Address - Fax:212-685-0694
Practice Address - Street 1:161 MADISON AVE
Practice Address - Street 2:SUITE 9NE
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-5421
Practice Address - Country:US
Practice Address - Phone:212-685-0594
Practice Address - Fax:212-685-0694
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY186816207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY6017793OtherGHI
NYP3180297OtherOXFORD
NYN87323OtherHEALTHNET
NY21N901Medicare ID - Type UnspecifiedPROVIDER #
NY6017793OtherGHI