Healthcare Provider Details

I. General information

NPI: 1659694669
Provider Name (Legal Business Name): ERALD ZYLAJ PHARM.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/04/2010
Last Update Date: 11/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1194 HYLAN BLVD
STATEN ISLAND NY
10305
US

IV. Provider business mailing address

1194 HYLAN BLVD
STATEN ISLAND NY
10305-1920
US

V. Phone/Fax

Practice location:
  • Phone: 718-524-8127
  • Fax: 718-524-6592
Mailing address:
  • Phone: 718-524-8127
  • Fax: 718-524-6592

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number053651
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: