Organization
KAN-DI-KI LLC
Active
Other names
TridentCare, Diagnostic Laboratories
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN C CUOMO (AUTHORIZED OFFICIAL/CFO)
(800) 786-8015
Entity
Organization
Contact information
Practice address
2502 E UNIVERSITY DR STE 290, PHOENIX, AZ 85034-6932
(602) 281-4225
(443) 842-7264
Mailing address
215 SCHILLING CIR STE 114, HUNT VALLEY, MD 21031-1113
(800) 786-8015
Taxonomy
Speciality
Code
Description
License number
State
2085U0001X
Diagnostic Ultrasound Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
517185
—
AZ
05
—
633245
—
AZ
01
—
P01005658
RAIL ROAD MEDICARE
AZ
01
—
Z144027
MEDICARE
AZ
Enumeration date
07/12/2010
Last updated
03/11/2026
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