Provider Demographics
NPI:1801130141
Name:CARDELLO, CATHERINE M (RN)
Entity type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:M
Last Name:CARDELLO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 TECUMSEH CT
Mailing Address - Street 2:
Mailing Address - City:GREENLAWN
Mailing Address - State:NY
Mailing Address - Zip Code:11740-1613
Mailing Address - Country:US
Mailing Address - Phone:631-754-9051
Mailing Address - Fax:
Practice Address - Street 1:75 LANDING MEADOW RD
Practice Address - Street 2:
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-1124
Practice Address - Country:US
Practice Address - Phone:631-360-4700
Practice Address - Fax:631-260-4798
Is Sole Proprietor?:No
Enumeration Date:2012-11-26
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY271064163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse