Healthcare Provider Details

I. General information

NPI: 1710933395
Provider Name (Legal Business Name): DANI M ZAVASKY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 MOULTRIE LANDING BLVD APT 9205
ST AUGUSTINE FL
32086-6184
US

IV. Provider business mailing address

400 MOULTRIE LANDING BLVD APT 9205
ST AUGUSTINE FL
32086-6184
US

V. Phone/Fax

Practice location:
  • Phone: 917-526-2311
  • Fax: 212-208-2425
Mailing address:
  • Phone: 917-526-2311
  • Fax: 212-208-2425

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number218368
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: