MEDICARE: MANSOOR ANWER ZAIDI MD

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	207R00000X	Internal Medicine Physician	232468	NY
2	207R00000X	Internal Medicine Physician	236499	MA
3	207R00000X	Internal Medicine Physician	50367	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2117653	OTHER	NY	CIGNA
3	1245941	OTHER	NY	AETNA - HMO
4	2117653	OTHER	NY	EMPIRE BC/BS
5	7699782	OTHER	NY	AETNA - PPO

General Provider Information

NPI Number	:	1861411647
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MANSOOR ANWER ZAIDI MD

Provider Business Mailing Address
First Line	:	575 BEECH ST
Second Line	:
City	:	HOLYOKE
State	:	MA
Zip	:	01040-2223
Country	:	US
Telephone Number	:	413-534-2570
Fax Number	:	413-534-2613

Provider Business Practice Location Address
First Line	:	447 SUMNER AVE
Second Line	:
City	:	SPRINGFIELD
State	:	MA
Zip	:	01108-2320
Country	:	US
Telephone Number	:	203-678-8006
Fax Number	:

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

Provider Enumeration Date	:	07/19/2006
Last Update Date	:	01/05/2024

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