Healthcare Provider Details

I. General information

NPI: 1609813351
Provider Name (Legal Business Name): MARJORIE M ZAKARIA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 LONGWOOD AVE CHILDREN'S HOSPITAL/ENDOCRINE DIV
BOSTON MA
02115-5711
US

IV. Provider business mailing address

253 NORFOLK ST
CAMBRIDGE MA
02139-1451
US

V. Phone/Fax

Practice location:
  • Phone: 617-665-8616
  • Fax:
Mailing address:
  • Phone: 617-665-8616
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License Number153410
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: