Provider Demographics
NPI:1821734294
Name:CEDARBAUM, VANESSA KESTEN (MD)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:KESTEN
Last Name:CEDARBAUM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 BRADLEY RD STE 102
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:CT
Mailing Address - Zip Code:06525-2235
Mailing Address - Country:US
Mailing Address - Phone:203-397-1243
Mailing Address - Fax:
Practice Address - Street 1:1 BRADLEY RD STE 102
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:CT
Practice Address - Zip Code:06525-2235
Practice Address - Country:US
Practice Address - Phone:203-397-1243
Practice Address - Fax:203-397-1241
Is Sole Proprietor?:No
Enumeration Date:2022-05-09
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT81747208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics