MEDICARE: DR. GABRIEL ZAYAT M.D.

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	207Q00000X	Family Medicine Physician	149657	NY

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	:	1851454557
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GABRIEL ZAYAT M.D.

Provider Business Mailing Address
First Line	:	35-24 78TH STREET
Second Line	:	#B-14
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11372-4750
Country	:	US
Telephone Number	:	718-639-2600
Fax Number	:	718-639-3065

Provider Business Practice Location Address
First Line	:	3524 78TH ST
Second Line	:	#B-14
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11372-4750
Country	:	US
Telephone Number	:	718-639-2600
Fax Number	:	718-639-3065

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

Provider Enumeration Date	:	12/18/2006
Last Update Date	:	09/06/2011

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