Individual
MS. NICOLE CARDILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT/CHT
Contact information
Practice address
95-390 KUAHELANI AVE, 1C, MILILANI, HI 96789-1192
(808) 445-4428
(806) 637-9592
Mailing address
91-1654 BURKE ST, EWA BEACH, HI 96706-2049
(808) 285-5457
(757) 321-3332
Taxonomy
Speciality
Code
Description
License number
State
225XH1200X
Hand Occupational Therapist
Primary
0119003304
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ANTHEM BC/BS
278740
VA
01
—
C05501
MEDICARE GROUP PTAN
VA
Enumeration date
07/07/2005
Last updated
04/11/2018
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