Lucien John B Cardinal, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

200627 Issued in NY

Practice address

75 N Country Rd
Port Jefferson, NY 11777-2119

Phone

(631) 686-2519

Fax

(631) 686-7972

NPI assigned

Oct 12, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383696000000",
    "number": "1306935150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 N COUNTRY RD",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772119",
            "telephone_number": "631-473-1320",
            "fax_number": "631-686-7972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 N COUNTRY RD",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772119",
            "telephone_number": "631-686-2519",
            "fax_number": "631-686-7972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARDINAL",
        "first_name": "LUCIEN",
        "middle_name": "JOHN B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2013-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "200627",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02334352",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher Gerald Callahan, LCSW, CASAC
• Cameron Callirgos
• Denine Cannistra, RD
• Michael J Cardillo, PH.D.
• Cardinal Mental Health Counseling, PLLC
• Barbara Carlstrom
• Susanne Carmello, LMFT
• Hilsha Carrion, DMD
• Wesley Vanwye Carrion
• Joseph M Carrucciu, MD

• Internal Medicine Physician in Port Jefferson, NY
• Providers in Port Jefferson, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.