Provider Demographics
NPI:1154752699
Name:ZAKLAMA, BADRAT N (CSA)
Entity type:Individual
Prefix:
First Name:BADRAT
Middle Name:N
Last Name:ZAKLAMA
Suffix:
Gender:M
Credentials:CSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 OLD GRANARY CT
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-5358
Mailing Address - Country:US
Mailing Address - Phone:410-900-3225
Mailing Address - Fax:
Practice Address - Street 1:4 OLD GRANARY CT
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-5358
Practice Address - Country:US
Practice Address - Phone:410-900-3225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-10
Last Update Date:2013-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant