# CEDAR LANE MEDICAL CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265688915
- **Authorized official:** DR. GARY E RAFFEL D.O. (PHYSICIAN, OWNER)
- **Authorized official phone:** (301) 816-2480

## Contact information

- **Practice address:** 11119 ROCKVILLE PIKE, SUITE 316, ROCKVILLE, MD 20852-3143
- **Practice address phone:** (301) 816-2480
- **Practice address fax:** (301) 816-2483
- **Mailing address:** 11119 ROCKVILLE PIKE, SUITE 316, ROCKVILLE, MD 20852-3143
- **Mailing address phone:** (301) 816-2480
- **Mailing address fax:** (301) 816-2483

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | H0045839 | MD | Yes |

## Other

- **Enumeration date:** 08/13/2008
- **Last updated:** 08/13/2008