MEDICARE: MR. PHILIP ZAM

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	183500000X	Pharmacist	03069	NY

General Provider Information

NPI Number	:	1164685152
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. PHILIP ZAM

Provider Business Mailing Address
First Line	:	1219 1ST AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10065-6801
Country	:	US
Telephone Number	:	212-838-1490
Fax Number	:	212-755-3543

Provider Business Practice Location Address
First Line	:	1219 1ST AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10065-6801
Country	:	US
Telephone Number	:	212-838-1490
Fax Number	:	212-755-3543

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

Provider Enumeration Date	:	07/09/2008
Last Update Date	:	07/09/2008

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Directions to “ MR. PHILIP ZAM ” Practice Location

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