Healthcare Provider Details

I. General information

NPI: 1700462173
Provider Name (Legal Business Name): AMARACHI CHINEDUM ZACHARIAH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2021
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

541 CLARKSON AVE FL 5
BROOKLYN NY
11203
US

IV. Provider business mailing address

439 WINTHROP ST
BROOKLYN NY
11203-1514
US

V. Phone/Fax

Practice location:
  • Phone: 718-245-3660
  • Fax:
Mailing address:
  • Phone: 347-677-6401
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number329484
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: