1114904059 NPI number — DR. ZIA A ZAKAI M.D.,P.A.,M.SC.

Table of content: DR. ZIA A ZAKAI M.D.,P.A.,M.SC. (NPI 1114904059)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114904059 NPI number — DR. ZIA A ZAKAI M.D.,P.A.,M.SC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ZAKAI
Provider First Name:
ZIA
Provider Middle Name:
A
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.,P.A.,M.SC.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1114904059
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/20/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
19 FONTANA LN
Provider Second Line Business Mailing Address:
SUITE 208-210
Provider Business Mailing Address City Name:
BALTIMORE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21237-3047
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-574-4720
Provider Business Mailing Address Fax Number:
410-574-6049

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
19 FONTANA LN
Provider Second Line Business Practice Location Address:
SUITE 208-210
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21237-3047
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-574-4720
Provider Business Practice Location Address Fax Number:
410-574-6049
Provider Enumeration Date:
12/30/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207X00000X , with the licence number:  D0026485 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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