Healthcare Provider Details

I. General information

NPI: 1457524076
Provider Name (Legal Business Name): TAMAR ZAPOLANSKI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2008
Last Update Date: 09/01/2022
Certification Date: 09/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 E RIDGEWOOD AVE STE 302E
RIDGEWOOD NJ
07450-3937
US

IV. Provider business mailing address

1200 E RIDGEWOOD AVE STE 302E
RIDGEWOOD NJ
07450-3937
US

V. Phone/Fax

Practice location:
  • Phone: 201-689-2103
  • Fax:
Mailing address:
  • Phone: 201-689-2103
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number255567
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: