Provider Demographics
NPI:1427339316
Name:CDMA MEDICAL CORPORATION, PSC
Entity type:Organization
Organization Name:CDMA MEDICAL CORPORATION, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ERNESTO
Authorized Official - Middle Name:B
Authorized Official - Last Name:HERGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-751-7799
Mailing Address - Street 1:AVE JESUS T PINERO 282
Mailing Address - Street 2:PLAZA EL AMAL SUITE 204
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00927
Mailing Address - Country:US
Mailing Address - Phone:787-751-7799
Mailing Address - Fax:787-296-8447
Practice Address - Street 1:AVE JESUS T PINERO # 282
Practice Address - Street 2:PLAZA EL AMAL SUITE 204
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-4003
Practice Address - Country:US
Practice Address - Phone:787-751-7799
Practice Address - Fax:787-296-8447
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CDMA MEDICAL CORPORATION, PSC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-09-06
Last Update Date:2011-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty