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General NPI Number Information
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NPI Number | 1992333652
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Entity Type | Individual
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Provider Name | ZACHARY BENJAMIN POLIACOFF MD
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Gender | Male
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Dates
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Enumeration Date | 03/30/2020
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Last Update Date | 07/13/2024
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Provider Practice Location Address
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Address Line | 462 1ST AVE
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City | NEW YORK
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State | NY
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Zip | 10016-9196
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Country | US
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Telephone | 212-263-6219
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Fax |
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Provider Business Mailing Address
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Address Line | 900 CARPENTER TOWN LN
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City | CARY
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State | NC
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Zip | 27519-9315
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Country | US
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Telephone | 305-965-0826
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Fax |
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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 | 329636
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License Number State | NY
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