Healthcare Provider Details

I. General information

NPI: 1295364404
Provider Name (Legal Business Name): ZAB'DI LANETTE SANCHEZ PRADA DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2020
Last Update Date: 05/15/2024
Certification Date: 05/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4433 VESTAL PKWY E
VESTAL NY
13850-3556
US

IV. Provider business mailing address

33 LEWIS RD FL 2
BINGHAMTON NY
13905
US

V. Phone/Fax

Practice location:
  • Phone: 607-772-8772
  • Fax:
Mailing address:
  • Phone: 607-770-0025
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number0103301391
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number0103301391
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number007308
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: