1033785258 NPI number — MR. ZAKARIYA TAREK KASHOUR MBBS

Table of content: MR. ZAKARIYA TAREK KASHOUR MBBS (NPI 1033785258)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033785258 NPI number — MR. ZAKARIYA TAREK KASHOUR MBBS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KASHOUR
Provider First Name:
ZAKARIYA
Provider Middle Name:
TAREK
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
MBBS
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:
1033785258
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/06/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
11/28/2022
NPI Reactivation Date:
04/06/2023

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
119600 26 AVE SW T6W 4P5
Provider Second Line Business Mailing Address:
#317
Provider Business Mailing Address City Name:
EDMONTON
Provider Business Mailing Address State Name:
AB
Provider Business Mailing Address Postal Code:
T6W 4P5
Provider Business Mailing Address Country Code:
CA
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2157 MAIN ST 5TH FLOOR
Provider Second Line Business Practice Location Address:
CHS INTERNAL MEDICINE TRAINING PROGRAM
Provider Business Practice Location Address City Name:
BUFFALO
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14214
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
716-862-1423
Provider Business Practice Location Address Fax Number:
716-862-1871
Provider Enumeration Date:
05/28/2021

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: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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