Provider Demographics
NPI:1679569255
Name:CARDINALE, JOSEPH P (DO)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:P
Last Name:CARDINALE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:879 S ARLINGTON AVE
Mailing Address - Street 2:STE 2
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17109-5004
Mailing Address - Country:US
Mailing Address - Phone:717-657-1424
Mailing Address - Fax:717-657-8887
Practice Address - Street 1:879 S ARLINGTON AVE
Practice Address - Street 2:STE 2
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17109-5004
Practice Address - Country:US
Practice Address - Phone:717-657-1424
Practice Address - Fax:717-657-8887
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-20
Last Update Date:2010-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA05003804L208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA510370OtherHIGHMARK BLUE SHIELD
PA03024900OtherCAPITAL BLUE CROSS
PA0006398210001Medicaid
PA03024900OtherCAPITAL BLUE CROSS
B37356Medicare UPIN