Healthcare Provider Details

I. General information

NPI: 1821189804
Provider Name (Legal Business Name): JUSUF ZLATANIC M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

132 E 76TH ST SUITE 2G
NEW YORK NY
10021-2850
US

IV. Provider business mailing address

132 E 76TH ST SUITE 2G
NEW YORK NY
10021-2850
US

V. Phone/Fax

Practice location:
  • Phone: 212-793-0833
  • Fax: 212-585-1764
Mailing address:
  • Phone: 212-793-0833
  • Fax: 212-585-1764

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number200008
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: