Healthcare Provider Details

I. General information

NPI: 1215385505
Provider Name (Legal Business Name): ZAHIA ZHORT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2016
Last Update Date: 05/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7823 BERGENLINE AVE
NORTH BERGEN NJ
07047-4942
US

IV. Provider business mailing address

7823 BERGENLINE AVE
NORTH BERGEN NJ
07047-4942
US

V. Phone/Fax

Practice location:
  • Phone: 201-868-9449
  • Fax:
Mailing address:
  • Phone: 201-868-9449
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number26NJ00627900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: