Healthcare Provider Details

I. General information

NPI: 1578323077
Provider Name (Legal Business Name): EMMA ZOUBEK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2024
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 PROSPECT AVE
HACKENSACK NJ
07601-1915
US

IV. Provider business mailing address

30 PROSPECT AVE 3RD FLOOR MAIN BUILDING- EMERGENCY MEDICINE
HACKENSACK NJ
07601
US

V. Phone/Fax

Practice location:
  • Phone: 631-742-2103
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberP25-00643
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: