Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 0101045340 | VA |
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 0101045340 | VA |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 160255 | NY |
NPI | 1144296336 |
---|---|
Provider Name | Dr. Kenneth R Zaslav |
First Address | North Chesterfield, VA 23225-4067 |
Second Address | Richmond, VA 23294 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2006 |
Last Update Date | 09/07/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E17921 | (02) |