Healthcare Provider Details

I. General information

NPI: 1922552181
Provider Name (Legal Business Name): BUSHRA ZIA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2016
Last Update Date: 08/31/2022
Certification Date: 08/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 HOSPITAL DR FL 3
HOLYOKE MA
01040-6601
US

IV. Provider business mailing address

262 NEW LUDLOW RD
CHICOPEE MA
01020-4324
US

V. Phone/Fax

Practice location:
  • Phone: 413-540-5048
  • Fax: 413-540-5049
Mailing address:
  • Phone: 413-535-4714
  • Fax: 413-535-4716

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number291000
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: