Healthcare Provider Details
I. General information
NPI: 1578572400
Provider Name (Legal Business Name): NAIF ZACOUR ABRAHAM JR. MD/PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/07/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
800 IRVING AVE
SYRACUSE NY
13210-2716
US
IV. Provider business mailing address
113 GREELEY CIR
LIVERPOOL NY
13090-3118
US
V. Phone/Fax
- Phone: 315-425-4801
- Fax:
- Phone: 315-453-0196
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207ZH0000X |
| Taxonomy | Hematology (Pathology) Physician |
| License Number | 180740-1 |
| License Number State | NY |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207ZP0102X |
| Taxonomy | Anatomic Pathology & Clinical Pathology Physician |
| License Number | 180740-1 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: