Healthcare Provider Details

I. General information

NPI: 1932855020
Provider Name (Legal Business Name): SUSAN ZONA-O'BYRNE PEDIATRICS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2022
Last Update Date: 03/03/2022
Certification Date: 03/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

98 ROSE AVE
STATEN ISLAND NY
10306-2242
US

IV. Provider business mailing address

211 MEISNER AVE
STATEN ISLAND NY
10306-1245
US

V. Phone/Fax

Practice location:
  • Phone: 718-351-9800
  • Fax: 646-867-2121
Mailing address:
  • Phone: 718-351-9745
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SUSAN ZONA-O'BYRNE
Title or Position: MEMBER
Credential: MD
Phone: 718-351-9745