MEDICARE: SEHAAM ZAMZAMI RPA-C

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	363A00000X	Physician Assistant	012795	NY

General Provider Information

NPI Number	:	1447490057
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SEHAAM ZAMZAMI RPA-C

Provider Business Mailing Address
First Line	:	2914 VOORHIES AVE APT 1
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-2112
Country	:	US
Telephone Number	:	347-424-6274
Fax Number	:

Provider Business Practice Location Address
First Line	:	506 LENOX AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10037-1802
Country	:	US
Telephone Number	:	212-939-4680
Fax Number	:

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

Provider Enumeration Date	:	02/23/2009
Last Update Date	:	02/23/2009

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