Provider Demographics
NPI:1760461651
Name:CYRIL MEDICAL ASSOCIATES LLC
Entity Type:Organization
Organization Name:CYRIL MEDICAL ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:
Authorized Official - First Name:ESSAM
Authorized Official - Middle Name:
Authorized Official - Last Name:RAGHEB
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-847-9911
Mailing Address - Street 1:5901 MAHONING AVE NW
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44483-1171
Mailing Address - Country:US
Mailing Address - Phone:330-847-9911
Mailing Address - Fax:
Practice Address - Street 1:5901 MAHONING AVE NW
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44483-1171
Practice Address - Country:US
Practice Address - Phone:330-847-9911
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-10
Last Update Date:2009-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35051795207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9310401Medicare PIN