Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 350502 | NY |
NPI | 1235751967 |
---|---|
Provider Name | Alexander Edward Joseph Zajac |
First Address | New York, NY 10032-1559 |
Second Address | New York, NY 10032-1559 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2020 |
Last Update Date | 29/10/2020 |