MEDICARE: ZAKIA IRUM

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	207R00000X	Internal Medicine Physician	P131305	NY

General Provider Information

NPI Number	:	1275351090
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZAKIA IRUM

Provider Business Mailing Address
First Line	:	196 ORIENT AVE
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07305-3691
Country	:	US
Telephone Number	:	551-208-9850
Fax Number	:

Provider Business Practice Location Address
First Line	:	1160 TELLER AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10456-4291
Country	:	US
Telephone Number	:	718-293-1500
Fax Number	:

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

Provider Enumeration Date	:	10/01/2024
Last Update Date	:	10/01/2024

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Directions to “ ZAKIA IRUM ” Practice Location

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