Healthcare Provider Details

I. General information

NPI: 1568034049
Provider Name (Legal Business Name): MISHAAL ZIA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2021
Last Update Date: 09/17/2024
Certification Date: 07/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 E ADAMS ST
SYRACUSE NY
13210-2306
US

IV. Provider business mailing address

750 E. ADAMS ST.
SYRACUSE NY
13210
US

V. Phone/Fax

Practice location:
  • Phone: 315-464-5240
  • Fax:
Mailing address:
  • Phone: 315-464-5910
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number331854
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: