Healthcare Provider Details

I. General information

NPI: 1073708038
Provider Name (Legal Business Name): JOSEPH A. ZAGAMI D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2007
Last Update Date: 04/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 W 58TH ST STE 605
NEW YORK NY
10019-1817
US

IV. Provider business mailing address

330 W 58TH ST STE 605
NEW YORK NY
10019-1817
US

V. Phone/Fax

Practice location:
  • Phone: 212-586-3585
  • Fax: 212-333-7998
Mailing address:
  • Phone: 212-586-3585
  • Fax: 212-333-7998

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number040209-2
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number22D102490000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: