Healthcare Provider Details

I. General information

NPI: 1134869050
Provider Name (Legal Business Name): ZOE ADAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2022
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

462 1ST AVE
NEW YORK NY
10016-9196
US

IV. Provider business mailing address

462 1ST AVE
NEW YORK NY
10016-9196
US

V. Phone/Fax

Practice location:
  • Phone: 617-726-5820
  • Fax:
Mailing address:
  • Phone: 617-726-5820
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number336573-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: