Provider Demographics
NPI:1124137369
Name:ARDITO, JOSEPH M (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:M
Last Name:ARDITO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:994 OLD EAGLE SCHOOL RD
Mailing Address - Street 2:STE 1017
Mailing Address - City:WAYNE
Mailing Address - State:PA
Mailing Address - Zip Code:19087-1802
Mailing Address - Country:US
Mailing Address - Phone:610-296-5600
Mailing Address - Fax:610-296-3308
Practice Address - Street 1:15 INDUSTRIAL BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:PAOLI
Practice Address - State:PA
Practice Address - Zip Code:19301-1608
Practice Address - Country:US
Practice Address - Phone:610-296-5600
Practice Address - Fax:610-296-3308
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2015-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD024840E174400000X, 207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery
No174400000XOther Service ProvidersSpecialist