Healthcare Provider Details

I. General information

NPI: 1649223090
Provider Name (Legal Business Name): KIM ZUBRINIC MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 09/12/2022
Certification Date: 09/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1476 DEER PARK AVE
NORTH BABYLON NY
11703-1200
US

IV. Provider business mailing address

1486 DEER PARK AVE UNIT A
NORTH BABYLON NY
11703
US

V. Phone/Fax

Practice location:
  • Phone: 631-635-5454
  • Fax:
Mailing address:
  • Phone: 631-422-3200
  • Fax: 631-422-6597

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number221855
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: