Organization
BAYLESS PATHMARK INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YILAN CHANG (PRESIDENT)
(440) 826-0384
Entity
Organization
Contact information
Practice address
19250 BAGLEY RD STE 101, MIDDLEBURG HEIGHTS, OH 44130-3348
(440) 826-0384
(440) 826-1910
Mailing address
19250 BAGLEY RD STE 101, MIDDLEBURG HEIGHTS, OH 44130-3348
(440) 826-0384
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2147788
—
OH
Enumeration date
05/01/2006
Last updated
01/30/2019
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