Provider Demographics
NPI:1548027386
Name:ZADRIMA, DOMINIQUE (PA-C)
Entity type:Individual
Prefix:
First Name:DOMINIQUE
Middle Name:
Last Name:ZADRIMA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 N CROSS RD
Mailing Address - Street 2:
Mailing Address - City:LAGRANGEVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12540-5200
Mailing Address - Country:US
Mailing Address - Phone:845-214-6350
Mailing Address - Fax:
Practice Address - Street 1:1915 CENTRAL PARK AVE
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10710-2949
Practice Address - Country:US
Practice Address - Phone:914-966-0505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-28
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant