Healthcare Provider Details

I. General information

NPI: 1699794867
Provider Name (Legal Business Name): DAVID D ZARGAROFF M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 10/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9229 QUEENS BLVD SUITE C-A
REGO PARK NY
11374-1056
US

IV. Provider business mailing address

9229 QUEENS BLVD SUITE C-A
REGO PARK NY
11374-1056
US

V. Phone/Fax

Practice location:
  • Phone: 718-575-1800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number158257
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: