Healthcare Provider Details

I. General information

NPI: 1184979809
Provider Name (Legal Business Name): ZIAD ESPER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2012
Last Update Date: 07/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

288 SLATER BLVD
STATEN ISLAND NY
10305-4046
US

IV. Provider business mailing address

288 SLATER BLVD.
STATEN ISLAND NY
10305
US

V. Phone/Fax

Practice location:
  • Phone: 646-522-0366
  • Fax:
Mailing address:
  • Phone: 646-522-0366
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberMD2017-1041
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: