Provider Demographics
NPI:1215624366
Name:CARDOSA, CAROLINE (PA-C)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:
Last Name:CARDOSA
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 1:63 GREENFIELD RD
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:RI
Mailing Address - Zip Code:02864-4712
Mailing Address - Country:US
Mailing Address - Phone:401-633-2958
Mailing Address - Fax:
Practice Address - Street 1:300 CROSSINGS BLVD
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-2878
Practice Address - Country:US
Practice Address - Phone:401-777-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-19
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant