Individual provider Active NPI

Glenda Ann Cardillo, M.D. MPH

  • Public Health & General Preventive Medicine Physician
  • Harrisburg, PA
National Provider Identifier
1659519858
Registry record updated Jan 26, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X
License
MD432127 Issued in PA
Practice address
1514 N 2ND St
Harrisburg, PA 17102-2505
Phone
(717) 234-2468
Fax
(717) 901-5351
NPI assigned
Jan 26, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health & General Preventive Medicine Physician 2083P0901X MD432127 PA Primary

Addresses

Primary practice location

1514 N 2ND St
Harrisburg, PA 17102-2505

Mailing address

1514 N 2ND St
Harrisburg, PA 17102-2505
Phone (717) 234-2468

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MD432127PAMDPublic Health & General Preventive Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1232928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232928000000",
    "number": "1659519858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1514 N 2ND ST",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171022505",
            "telephone_number": "717-234-2468",
            "fax_number": "717-901-5351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1514 N 2ND ST",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171022505",
            "telephone_number": "717-234-2468",
            "fax_number": "717-901-5351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARDILLO",
        "first_name": "GLENDA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "M.D.   MPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-26",
        "last_updated": "2009-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "PA",
            "license": "MD432127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2009; 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.