1750475646 NPI number — JEANETTE M S ZAIMES MD

Table of content: (NPI 1750475646)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750475646 NPI number — JEANETTE M S ZAIMES MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JEANETTE M S ZAIMES MD
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1750475646
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/21/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
308 E STEIN HGHWAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SEAFORD
Provider Business Mailing Address State Name:
DE
Provider Business Mailing Address Postal Code:
19973-1416
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
302-628-7781
Provider Business Mailing Address Fax Number:
302-628-7783

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
308 E STEIN HGHWAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SEAFORD
Provider Business Practice Location Address State Name:
DE
Provider Business Practice Location Address Postal Code:
19973-1416
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
302-628-7781
Provider Business Practice Location Address Fax Number:
302-628-7783
Provider Enumeration Date:
10/03/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ZAIMES
Authorized Official First Name:
JEANETTE
Authorized Official Middle Name:
M.S.
Authorized Official Title or Position:
OWNER/PRESIDENT
Authorized Official Telephone Number:
302-628-7781

Provider Taxonomy Codes

  • Taxonomy code: 2084P0800X , with the licence number:  C1 0004483 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1801816624 . This is a "NPI" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: 0000916802 , issued by the state of ( DE ) . This identifiers is of the category "MEDICAID".




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