Provider Demographics
NPI:1730762717
Name:ZAKARIA, TASNIM (OD)
Entity type:Individual
Prefix:
First Name:TASNIM
Middle Name:
Last Name:ZAKARIA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 SICOMAC RD
Mailing Address - Street 2:
Mailing Address - City:NORTH HALEDON
Mailing Address - State:NJ
Mailing Address - Zip Code:07508-2971
Mailing Address - Country:US
Mailing Address - Phone:973-427-7801
Mailing Address - Fax:
Practice Address - Street 1:33 SICOMAC RD
Practice Address - Street 2:
Practice Address - City:NORTH HALEDON
Practice Address - State:NJ
Practice Address - Zip Code:07508-2971
Practice Address - Country:US
Practice Address - Phone:973-427-7801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-28
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA-00706200152W00000X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist