1578899514 NPI number — R ZAKARIA PHYSICIAN PLLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578899514 NPI number — R ZAKARIA PHYSICIAN PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
R ZAKARIA PHYSICIAN PLLC
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:
MUHAMMAD REZA ZAKARIA MD SOLE MBR
Provider Other Organization Name Type Code:
5
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:
1578899514
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/26/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
532 NEPTUNE AVE RM 209
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BROOKLYN
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11224-4008
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
917-627-6677
Provider Business Mailing Address Fax Number:
917-423-0410

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
532 NEPTUNE AVE RM 209
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11224-4008
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
917-627-6677
Provider Business Practice Location Address Fax Number:
917-423-0410
Provider Enumeration Date:
10/27/2009

Additional Information

Authorized Official

Authorized Official Last Name:
ZAKARIA
Authorized Official First Name:
MUHAMMAD
Authorized Official Middle Name:
REZA
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
917-627-6677

Provider Taxonomy Codes

  • Taxonomy code: 261QP2300X , with the licence number:  197646 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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