Healthcare Provider Details

I. General information

NPI: 1992961775
Provider Name (Legal Business Name): SERGEY ZASYPAYKO M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2008
Last Update Date: 01/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 BUSINESS PARK DRIVE
BRANFORD CT
06405
US

IV. Provider business mailing address

14 BUSINESS PARK DR
BRANFORD CT
06405-2909
US

V. Phone/Fax

Practice location:
  • Phone: 203-643-0620
  • Fax: 203-643-0623
Mailing address:
  • Phone: 203-643-0620
  • Fax: 203-643-0623

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number048353
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number249366
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: