Provider Demographics
NPI:1457710634
Name:CARDAMONE, GABRIELLE (PA-C)
Entity Type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:
Last Name:CARDAMONE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29325 HEALTH CAMPUS DR STE 3
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-8201
Mailing Address - Country:US
Mailing Address - Phone:440-414-9400
Mailing Address - Fax:440-808-3618
Practice Address - Street 1:7255 OLD OAK BLVD STE C408
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44130-3331
Practice Address - Country:US
Practice Address - Phone:440-414-9500
Practice Address - Fax:440-260-0552
Is Sole Proprietor?:No
Enumeration Date:2016-02-17
Last Update Date:2019-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.004549RX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant