Provider Demographics
NPI:1669234134
Name:ARDANE MEDICAL LLC
Entity type:Organization
Organization Name:ARDANE MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:NIEVES ROSADO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-287-7081
Mailing Address - Street 1:2036 WESTVIEW PT
Mailing Address - Street 2:
Mailing Address - City:SENECA
Mailing Address - State:SC
Mailing Address - Zip Code:29672-2436
Mailing Address - Country:US
Mailing Address - Phone:917-287-7081
Mailing Address - Fax:
Practice Address - Street 1:528 US-123 BYPASS
Practice Address - Street 2:SUITE C
Practice Address - City:SENECA
Practice Address - State:SC
Practice Address - Zip Code:29678
Practice Address - Country:US
Practice Address - Phone:864-973-6755
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care