Healthcare Provider Details

I. General information

NPI: 1780417501
Provider Name (Legal Business Name): ZANYAH AGARD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2024
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 MEYER RD APT 101
BUFFALO NY
14226-1007
US

IV. Provider business mailing address

168 HENDRIX ST APT 4B
BROOKLYN NY
11207-2600
US

V. Phone/Fax

Practice location:
  • Phone: 347-451-8480
  • Fax:
Mailing address:
  • Phone: 347-451-8480
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: