Healthcare Provider Details

I. General information

NPI: 1346176542
Provider Name (Legal Business Name): ALFREDA K ZAIZAY II
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 4TH ST N
MOORHEAD MN
56560-1955
US

IV. Provider business mailing address

1321 13 1/2 ST S APT 101
FARGO ND
58103-3948
US

V. Phone/Fax

Practice location:
  • Phone: 218-233-3519
  • Fax:
Mailing address:
  • Phone: 701-970-6410
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: