Provider Demographics
NPI:1205947132
Name:NORWALK CARDIAC THORACIC & ENDOVASCULAR THERAPIES, INC.
Entity type:Organization
Organization Name:NORWALK CARDIAC THORACIC & ENDOVASCULAR THERAPIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:JON
Authorized Official - Last Name:ZADEH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:419-668-1155
Mailing Address - Street 1:48 EXECUTIVE DR
Mailing Address - Street 2:STE C
Mailing Address - City:NORWALK
Mailing Address - State:OH
Mailing Address - Zip Code:44857
Mailing Address - Country:US
Mailing Address - Phone:419-668-1155
Mailing Address - Fax:419-668-1145
Practice Address - Street 1:48 EXECUTIVE DR
Practice Address - Street 2:STE C
Practice Address - City:NORWALK
Practice Address - State:OH
Practice Address - Zip Code:44857
Practice Address - Country:US
Practice Address - Phone:419-668-1155
Practice Address - Fax:419-668-1145
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2012-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH088362208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty