Individual
DR. MICHAEL J CARDILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
41 N COUNTRY RD, OFFICE #1, PORT JEFFERSON, NY 11777-2160
(631) 473-0020
Mailing address
41 N COUNTRY RD, OFFICE #1, PORT JEFFERSON, NY 11777-2160
(631) 473-0020
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6906
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0010451
GHI ID
NY
01
—
147518
VALUE OPTIONS
NY
Enumeration date
12/22/2006
Last updated
07/08/2007
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