Provider Demographics
NPI:1457814758
Name:ZDOROVIE ADH NEEDHAM
Entity Type:Organization
Organization Name:ZDOROVIE ADH NEEDHAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:BAUDY
Authorized Official - Middle Name:
Authorized Official - Last Name:MAZAEV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:857-488-2399
Mailing Address - Street 1:185 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02494-2810
Mailing Address - Country:US
Mailing Address - Phone:781-433-9855
Mailing Address - Fax:
Practice Address - Street 1:185 2ND AVE
Practice Address - Street 2:
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02494-2810
Practice Address - Country:US
Practice Address - Phone:781-433-9855
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-12
Last Update Date:2019-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care