MEDICARE: CBLPATH, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	291U00000X	Clinical Medical Laboratory	3954	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205834769
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CBLPATH, INC

Provider Business Mailing Address
First Line	:	110 WASHINGTON AVE
Second Line	:	2ND FLOOR
City	:	NORTH HAVEN
State	:	CT
Zip	:	06473-1723
Country	:	US
Telephone Number	:	203-584-9406
Fax Number	:	203-985-2942

Provider Business Practice Location Address
First Line	:	760 WESTCHESTER AVE
Second Line	:
City	:	RYE BROOK
State	:	NY
Zip	:	10573-1341
Country	:	US
Telephone Number	:	914-698-5706
Fax Number	:	914-698-6624

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. CIRIL C RIZK
Credential	:	MD
Telephone Number	:	914-698-5706

Provider Enumeration Date	:	07/08/2005
Last Update Date	:	10/29/2025

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