Provider Demographics
NPI:1134430804
Name:CARDONA, LINA MARCELA (MD)
Entity type:Individual
Prefix:DR
First Name:LINA
Middle Name:MARCELA
Last Name:CARDONA
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 1:320 E 46TH ST APT 20G
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-3026
Mailing Address - Country:US
Mailing Address - Phone:646-265-4493
Mailing Address - Fax:
Practice Address - Street 1:320 E 46TH ST APT 20G
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-3026
Practice Address - Country:US
Practice Address - Phone:646-265-4493
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-28
Last Update Date:2010-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY257563207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine