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General NPI Number Information
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NPI Number | 1306395819
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Entity Type | Organization
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Legal Business Name | CIGANEK LLC
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Dates
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Enumeration Date | 09/26/2016
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Last Update Date | 09/26/2016
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Provider Practice Location Address
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Address Line | 633 RAILROAD AVE
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City | CENTREVILLE
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State | MD
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Zip | 21617-1144
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Country | US
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Telephone | 410-758-2732
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Fax | 410-758-0012
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Provider Business Mailing Address
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Address Line | 633 RAILROAD AVE
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City | CENTREVILLE
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State | MD
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Zip | 21617-1144
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Country | US
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Telephone | 410-758-2732
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Fax | 410-758-0012
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ERIC CIGANEK
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Credential |
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Telephone | 410-758-2732
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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