Healthcare Provider Details

I. General information

NPI: 1366605420
Provider Name (Legal Business Name): ADAM DANIEL ZAVODNICK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2008
Last Update Date: 01/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 BOND ST SUITE 1CA
GREAT NECK NY
11021-2433
US

IV. Provider business mailing address

7 BOND ST SUITE 1CA
GREAT NECK NY
11021-2433
US

V. Phone/Fax

Practice location:
  • Phone: 347-829-5211
  • Fax: 347-824-2952
Mailing address:
  • Phone: 347-829-5211
  • Fax: 347-824-2952

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number60277032
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: