Provider Demographics
NPI:1205844362
Name:ZAIDNER, EDUARDO YOSI (MD)
Entity Type:Individual
Prefix:
First Name:EDUARDO
Middle Name:YOSI
Last Name:ZAIDNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1611 CAMBRIDGE ST
Mailing Address - Street 2:BEHAVIORAL HEALTH
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138-4302
Mailing Address - Country:US
Mailing Address - Phone:617-661-5515
Mailing Address - Fax:617-661-5182
Practice Address - Street 1:1611 CAMBRIDGE ST
Practice Address - Street 2:BEHAVIORAL HEALTH
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-4302
Practice Address - Country:US
Practice Address - Phone:617-661-5515
Practice Address - Fax:617-661-5182
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2012-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2254212084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA001214703Medicare PIN