Basic Information
Provider Information | |||||||||
NPI: | 1568678225 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | ZAIDI | ||||||||
FirstName: | SYED | ||||||||
MiddleName: | F | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | MD | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | P.O. BOX 72384 | ||||||||
Address2: | RADIOLOGY ASSOCIATES OF CANTON, INC | ||||||||
City: | CLEVELAND | ||||||||
State: | OH | ||||||||
PostalCode: | 44192 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8886861837 | ||||||||
FaxNumber: | 3306865928 | ||||||||
Practice Location | |||||||||
Address1: | 2600 6TH ST SW | ||||||||
Address2: | RADIOLOGY ASSOCIATES OF CANTON, INC | ||||||||
City: | CANTON | ||||||||
State: | OH | ||||||||
PostalCode: | 447101702 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 3303632842 | ||||||||
FaxNumber: | 3305805536 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 05/16/2007 | ||||||||
LastUpdateDate: | 10/18/2021 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | M | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: | 10/18/2021 |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085B0100X | 35089685 | OH | N |   | Allopathic & Osteopathic Physicians | Radiology | Body Imaging | 2085R0202X | 35 089685 | OH | N |   | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 2085R0204X | 35 089685 | OH | Y |   | Allopathic & Osteopathic Physicians | Radiology | Vascular & Interventional Radiology |
ID Information
ID | Type | State | Issuer | Description | P00423244 | 01 | OH | RAILROAD MEDICARE | OTHER | 2774289 | 05 | OH |   | MEDICAID |