Organization
PROVIDERCARE PLUS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILIP S. CARDAMONE PSYD (DIRECTOR & CLINICAL PSYCHOLOGIST)
(860) 644-4472
Entity
Organization
Contact information
Practice address
152 DEMING ST, PROVIDERCARE PLUS, SOUTH WINDSOR, CT 06074-3740
(860) 644-4472
(860) 644-3001
Mailing address
152 DEMING ST, PROVIDERCARE PLUS, SOUTH WINDSOR, CT 06074-3740
(860) 644-4472
(860) 644-3001
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004398055
—
CT
Enumeration date
01/12/2006
Last updated
02/12/2013
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