Provider Demographics
NPI:1407991532
Name:CARDONE REPRODUCTIVE MEDICINE & INFERTILITY, LLC
Entity type:Organization
Organization Name:CARDONE REPRODUCTIVE MEDICINE & INFERTILITY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:VITO
Authorized Official - Middle Name:R S
Authorized Official - Last Name:CARDONE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:781-438-9600
Mailing Address - Street 1:2 MAIN ST
Mailing Address - Street 2:SUITE 150
Mailing Address - City:STONEHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02180-3335
Mailing Address - Country:US
Mailing Address - Phone:781-438-9600
Mailing Address - Fax:781-438-9601
Practice Address - Street 1:2 MAIN ST
Practice Address - Street 2:SUITE 150
Practice Address - City:STONEHAM
Practice Address - State:MA
Practice Address - Zip Code:02180-3335
Practice Address - Country:US
Practice Address - Phone:781-438-9600
Practice Address - Fax:781-438-9601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA56751207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive EndocrinologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA25276OtherFALLON
MA712663OtherTUFTS HEALTH PLAN
MAJ06571OtherBLUE CROSS BLUE SHIELD MA
MA1380826OtherAETNA
MAJ06571OtherBLUE CROSS BLUE SHIELD MA
MA1380826OtherAETNA
MA25276OtherFALLON