MEDICARE: DR. DIANA S ZABARKO OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	27TO00124001	NJ
2	152W00000X	Optometrist	27T000124001	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073611018
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DIANA S ZABARKO OD

Provider Business Mailing Address
First Line	:	1690 RATZER RD
Second Line	:
City	:	WAYNE
State	:	NJ
Zip	:	07470
Country	:	US
Telephone Number	:	917-327-3811
Fax Number	:	973-904-3339

Provider Business Practice Location Address
First Line	:	2703 BERGENLINE AVE
Second Line	:
City	:	UNION CITY
State	:	NJ
Zip	:	07087-3721
Country	:	US
Telephone Number	:	201-866-2011
Fax Number	:	201-866-2012

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/21/2006
Last Update Date	:	02/06/2014

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