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General NPI Number Information
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NPI Number | 1922416205
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Entity Type | Organization
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Legal Business Name | KZARK MEDICAL P.C.
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Dates
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Enumeration Date | 07/30/2014
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Last Update Date | 07/30/2014
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Provider Practice Location Address
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Address Line | 2391 BELL BLVD
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City | BAYSIDE
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State | NY
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Zip | 11360-2000
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Country | US
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Telephone | 718-626-2222
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5549
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City | ASTORIA
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State | NY
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Zip | 11105-5549
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Country | US
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Telephone | 718-626-2222
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Fax | 718-626-4962
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | KONSTANTINOS ZARKADAS
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Credential | M.D.
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Telephone | 347-613-5875
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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 |
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License Number State |
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