MEDICARE: IGOR ZAKHAROV DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	228868	NY

General Provider Information

NPI Number	:	1043389539
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IGOR ZAKHAROV DO

Provider Business Mailing Address
First Line	:	2748 OCEAN AVE
Second Line	:	FL 7
City	:	BROOKLYN
State	:	NY
Zip	:	11229-4708
Country	:	US
Telephone Number	:	347-492-6732
Fax Number	:	347-492-6735

Provider Business Practice Location Address
First Line	:	2748 OCEAN AVE
Second Line	:	FL 7
City	:	BROOKLYN
State	:	NY
Zip	:	11229-4708
Country	:	US
Telephone Number	:	347-492-6732
Fax Number	:	347-492-6735

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/07/2006
Last Update Date	:	11/28/2016

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