1780430405 NPI number — MS. MERCEDES MARCELA CARDENAS ONA M.D.

Table of content: MS. MERCEDES MARCELA CARDENAS ONA M.D. (NPI 1780430405)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780430405 NPI number — MS. MERCEDES MARCELA CARDENAS ONA M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CARDENAS ONA
Provider First Name:
MERCEDES
Provider Middle Name:
MARCELA
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1780430405
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/06/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
12/31/2024
NPI Reactivation Date:
03/06/2025

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
CAMINOS DEL INCA 145
Provider Second Line Business Mailing Address:
D-12
Provider Business Mailing Address City Name:
LIMA
Provider Business Mailing Address State Name:
LIMA
Provider Business Mailing Address Postal Code:
15086
Provider Business Mailing Address Country Code:
PE
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
263 FARMINGTON AVENUE
Provider Second Line Business Practice Location Address:
INTERNAL MEDICINE RESIDENCY PROGRAM
Provider Business Practice Location Address City Name:
FARMINGTON
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06030
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
860-679-2147
Provider Business Practice Location Address Fax Number:
860-679-4624
Provider Enumeration Date:
04/24/2024

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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