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General NPI Number Information
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NPI Number | 1275582165
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Entity Type | Individual
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Provider Name | KISHOR ZINZUVADIA M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/08/2006
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Last Update Date | 10/08/2024
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Provider Practice Location Address
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Address Line | 488 FREEDOM PLAINS RD STE 123
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City | POUGHKEEPSIE
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State | NY
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Zip | 12603-2697
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Country | US
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Telephone | 845-483-8743
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Fax | 845-485-3809
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Provider Business Mailing Address
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Address Line | 1 ASH CT
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City | POUGHKEEPSIE
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State | NY
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Zip | 12603-3732
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Country | US
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Telephone | 845-452-7975
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Fax | 845-452-2751
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 1669881
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License Number State | NY
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