Healthcare Provider Details

I. General information

NPI: 1437195427
Provider Name (Legal Business Name): IMRAN ZAFFER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2006
Last Update Date: 05/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

755 PARK AVE SUITE 200
HUNTINGTON NY
11743-3975
US

IV. Provider business mailing address

755 PARK AVE SUITE 200
HUNTINGTON NY
11743-3975
US

V. Phone/Fax

Practice location:
  • Phone: 631-683-4235
  • Fax:
Mailing address:
  • Phone: 631-683-4235
  • Fax: 631-683-4238

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number0017972
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number244910
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: