Healthcare Provider Details

I. General information

NPI: 1306306964
Provider Name (Legal Business Name): ELIZABETH ANNMARIE ZIPF MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2019
Last Update Date: 05/16/2022
Certification Date: 05/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 10TH AVE
NEW YORK NY
10019-1147
US

IV. Provider business mailing address

183 BAY AVE
HALESITE NY
11743-1135
US

V. Phone/Fax

Practice location:
  • Phone: 212-523-8663
  • Fax: 212-523-8605
Mailing address:
  • Phone: 347-804-4073
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number315852
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: