Healthcare Provider Details

I. General information

NPI: 1831260777
Provider Name (Legal Business Name): MAURICIO ZAPIACH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 60TH ST
WEST NEW YORK NJ
07093-2805
US

IV. Provider business mailing address

4 JOHNSON AVE
ENGLEWOOD CLIFFS NJ
07632-2107
US

V. Phone/Fax

Practice location:
  • Phone: 201-854-4646
  • Fax: 201-854-3203
Mailing address:
  • Phone: 201-854-4646
  • Fax: 201-854-3203

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMA07282800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: