Provider Demographics
NPI:1861215543
Name:CARDAMURO, AGOSTINA NANCY
Entity type:Individual
Prefix:
First Name:AGOSTINA
Middle Name:NANCY
Last Name:CARDAMURO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2054 LAMPLIGHTER DR
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-5916
Mailing Address - Country:US
Mailing Address - Phone:267-474-1337
Mailing Address - Fax:
Practice Address - Street 1:2054 LAMPLIGHTER DR
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-5916
Practice Address - Country:US
Practice Address - Phone:267-474-1337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-01
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician