Healthcare Provider Details

I. General information

NPI: 1396396206
Provider Name (Legal Business Name): GOLSA ZEIARATI PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2019
Last Update Date: 09/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 MINKEL RD
OSSINING NY
10562-2127
US

IV. Provider business mailing address

19 MINKEL RD
OSSINING NY
10562-2127
US

V. Phone/Fax

Practice location:
  • Phone: 914-572-7708
  • Fax:
Mailing address:
  • Phone: 914-572-7708
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License Number054254
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: