Healthcare Provider Details

I. General information

NPI: 1447419510
Provider Name (Legal Business Name): HEIDI J ZAPATA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2008
Last Update Date: 10/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 CEDAR ST
NEW HAVEN CT
06519-1612
US

IV. Provider business mailing address

15 YORK ST
NEW HAVEN CT
06510-3221
US

V. Phone/Fax

Practice location:
  • Phone: 203-785-7571
  • Fax:
Mailing address:
  • Phone: 203-688-5303
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number052420
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number052420
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: