Provider Demographics
NPI:1861176638
Name:ZALA, HARSHVARDHAN SAHADEVSINH
Entity type:Individual
Prefix:
First Name:HARSHVARDHAN
Middle Name:SAHADEVSINH
Last Name:ZALA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9366 BENCHVIEW DR APT D
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46240-1298
Mailing Address - Country:US
Mailing Address - Phone:862-242-9226
Mailing Address - Fax:
Practice Address - Street 1:725 IRVING AVE STE 311
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-1685
Practice Address - Country:US
Practice Address - Phone:315-464-5815
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-13
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program