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General NPI Number Information
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NPI Number | 1073797841
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Entity Type | Organization
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Legal Business Name | CEDARZ MEDICAL AND COSMEDICS,INC.
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Dates
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Enumeration Date | 12/28/2007
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Last Update Date | 03/14/2008
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Provider Practice Location Address
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Address Line | 812 METACOM AVE
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City | BRISTOL
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State | RI
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Zip | 02809-5160
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Country | US
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Telephone | 401-253-0025
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Fax |
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Provider Business Mailing Address
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Address Line | 812 METACOM AVENUE
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City | BRISTOL
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State | RI
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Zip | 02809
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Country | US
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Telephone | 401-253-0025
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MICHAEL Y BAAKLINI
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Credential | M.D.
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Telephone | 401-253-0025
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 9894
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License Number State | RI
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Taxonomy #2
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 7640
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License Number State | RI
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