Healthcare Provider Details

I. General information

NPI: 1497720056
Provider Name (Legal Business Name): JOHN ZAFARANLOO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/17/2006
Last Update Date: 05/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 DONGAN HILLS AVE STE 2A
STATEN ISLAND NY
10305-1224
US

IV. Provider business mailing address

235 DONGAN HILLS AVE STE 2A
STATEN ISLAND NY
10305-1224
US

V. Phone/Fax

Practice location:
  • Phone: 718-351-7650
  • Fax: 718-351-7615
Mailing address:
  • Phone: 718-351-7650
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number232949
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: