Provider Demographics
NPI:1760633556
Name:ZABLOCKI, CHANA SHIRA (MD)
Entity type:Individual
Prefix:
First Name:CHANA
Middle Name:SHIRA
Last Name:ZABLOCKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:845 JEROME AVE
Mailing Address - Street 2:
Mailing Address - City:HILLSIDE
Mailing Address - State:NJ
Mailing Address - Zip Code:07205-3107
Mailing Address - Country:US
Mailing Address - Phone:908-764-5587
Mailing Address - Fax:
Practice Address - Street 1:418 PALMER ST
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07202-3710
Practice Address - Country:US
Practice Address - Phone:908-820-4250
Practice Address - Fax:908-820-4252
Is Sole Proprietor?:No
Enumeration Date:2008-10-10
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08484300207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine