Healthcare Provider Details

I. General information

NPI: 1003566415
Provider Name (Legal Business Name): KENNETH ZON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2022
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 W 27TH ST RM 5S
NEW YORK NY
10001-6208
US

IV. Provider business mailing address

5440 LINTON BLVD # 247
DELRAY BEACH FL
33484-6512
US

V. Phone/Fax

Practice location:
  • Phone: 917-634-5311
  • Fax: 888-815-3583
Mailing address:
  • Phone: 561-334-6240
  • Fax: 561-495-3467

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberW7799
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number345635
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME182956
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: