Provider Demographics
NPI:1386398303
Name:RAKOTOMALALA, CEDRIC A
Entity type:Individual
Prefix:
First Name:CEDRIC
Middle Name:A
Last Name:RAKOTOMALALA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 E 128TH ST APT 9
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10035-1262
Mailing Address - Country:US
Mailing Address - Phone:516-605-4025
Mailing Address - Fax:
Practice Address - Street 1:19 E 128TH ST APT 9
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10035-1262
Practice Address - Country:US
Practice Address - Phone:516-605-4025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-08
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist