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NPI Code Detail

MEDICARE: JONATHAN D ZELLAN MD

MEDICARE: JONATHAN D ZELLAN MD
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
1207RI0200XInfectious Disease Physician215793NY

Other Identifiers

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

General Provider Information

NPI Number : 1154486082
Entity Type Code : Individual
Provider Name (Legal Business Name) : JONATHAN D ZELLAN MD
Provider Business Mailing Address
First Line : 803 STERLING PL
Second Line :
City : BROOKLYN
State : NY
Zip : 11216-3903
Country : US
Telephone Number : 718-613-1700
Fax Number : 718-735-6382
Provider Business Practice Location Address
First Line : 803 STERLING PL
Second Line :
City : BROOKLYN
State : NY
Zip : 11216-3903
Country : US
Telephone Number : 718-613-1700
Fax Number : 718-735-6382
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/22/2006
Last Update Date : 03/01/2011

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