MEDICARE: HUMZA ZAIDI

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	390200000X	Student in an Organized Health Care Education/Training Program		MA

General Provider Information

NPI Number	:	1124956362
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HUMZA ZAIDI

Provider Business Mailing Address
First Line	:	10 SKY VIEW DR
Second Line	:
City	:	AVON
State	:	CT
Zip	:	06001-2885
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	170 MORTON ST
Second Line	:
City	:	JAMAICA PLAIN
State	:	MA
Zip	:	02130-3735
Country	:	US
Telephone Number	:	617-522-8110
Fax Number	:

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

Provider Enumeration Date	:	05/09/2026
Last Update Date	:	05/09/2026

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