Provider Demographics
NPI:1215628011
Name:DENNIS A CARDILLO
Entity type:Organization
Organization Name:DENNIS A CARDILLO
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:ARMAND
Authorized Official - Last Name:CARDILLO
Authorized Official - Suffix:SR
Authorized Official - Credentials:OD
Authorized Official - Phone:609-315-2784
Mailing Address - Street 1:714 STATION AVE
Mailing Address - Street 2:
Mailing Address - City:HADDON HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:08035-1636
Mailing Address - Country:US
Mailing Address - Phone:609-546-8686
Mailing Address - Fax:856-546-8686
Practice Address - Street 1:714 STATION AVE
Practice Address - Street 2:
Practice Address - City:HADDON HEIGHTS
Practice Address - State:NJ
Practice Address - Zip Code:08035-1636
Practice Address - Country:US
Practice Address - Phone:856-546-8686
Practice Address - Fax:856-546-0959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-15
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty