Provider Demographics
NPI:1548925431
Name:ZAROOM, MAZAL
Entity type:Individual
Prefix:
First Name:MAZAL
Middle Name:
Last Name:ZAROOM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3406 AVENUE K
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-4145
Mailing Address - Country:US
Mailing Address - Phone:347-586-3937
Mailing Address - Fax:
Practice Address - Street 1:3406 AVENUE K
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11210-4145
Practice Address - Country:US
Practice Address - Phone:347-586-3937
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-04
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant