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General NPI Number Information
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NPI Number | 1760841829
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Entity Type | Organization
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Legal Business Name | I ZAKHAROV MEDICAL PC
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Dates
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Enumeration Date | 02/17/2016
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Last Update Date | 05/13/2016
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Provider Practice Location Address
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Address Line | 2748 OCEAN AVE 7 FLOOR
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City | BROOKLYN
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State | NY
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Zip | 11229-4708
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Country | US
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Telephone | 646-286-3210
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Fax | 718-247-7382
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Provider Business Mailing Address
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Address Line | 2748 OCEAN AVE 7 FLOOR
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City | BROOKLYN
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State | NY
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Zip | 11229-4708
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Country | US
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Telephone | 347-492-6732
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Fax | 347-492-6735
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Authorized Official
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Title or Position | OWNER
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Name | IGOR ZAKHAROV
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Credential | DO
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Telephone | 347-492-6732
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 228868
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License Number State | NY
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