Provider Demographics
NPI:1679292395
Name:CONRAD F CEAN MD, PLLC
Entity type:Organization
Organization Name:CONRAD F CEAN MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXEC. OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:CONRAD
Authorized Official - Middle Name:F
Authorized Official - Last Name:CEAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:888-789-6672
Mailing Address - Street 1:1400 5TH AVE APT 3E
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10026-2585
Mailing Address - Country:US
Mailing Address - Phone:888-789-6672
Mailing Address - Fax:646-862-9066
Practice Address - Street 1:941 BURKE AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469-3814
Practice Address - Country:US
Practice Address - Phone:888-789-6672
Practice Address - Fax:646-862-9066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-25
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty