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NPI Code Detail

MEDICARE: MS. ZAZA SAMIR SAKHAT LICSW

MEDICARE: MS. ZAZA SAMIR SAKHAT LICSW
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
11041C0700XClinical Social Worker114483MA

General Provider Information

NPI Number : 1124310016
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ZAZA SAMIR SAKHAT LICSW
Provider Business Mailing Address
First Line : 234 COPELAND ST
Second Line :
City : QUINCY
State : MA
Zip : 02169-4081
Country : US
Telephone Number : 617-786-0137
Fax Number :
Provider Business Practice Location Address
First Line : 234 COPELAND ST
Second Line :
City : QUINCY
State : MA
Zip : 02169-4081
Country : US
Telephone Number : 617-786-0137
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2011
Last Update Date : 05/10/2011

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