Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 000749 | CT |
Y | 222Z00000X | Podiatrist | 000749 | CT |
N | 213EP0504X | Public Medicine | 000749 | CT |
N | 213EP1101X | Primary Podiatric Medicine | 000749 | CT |
N | 111NR0200X | Radiology | 000749 | CT |
N | 213ER0200X | Radiology | 000749 | CT |
N | 2081S0010X | Sports Medicine | 000749 | CT |
N | 213ES0000X | Sports Medicine | 000749 | CT |
N | 213ES0131X | Foot Surgery | 000749 | CT |
NPI | 1851392138 |
---|---|
Provider Name | Dr. Samir F Zaky |
First Address | Bethel, CT 06801-2624 |
Second Address | Bethel, CT 06801-2624 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2005 |
Last Update Date | 30/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
030000749CT02 | BC/BS AND BLUE CARE (01) | CT |
4702850001 | DEMRC (01) | CT |
9577804 | CIGNA (01) | CT |
P00058892 | RAILROAD MEDICARE (01) | CT |
P2630726 | OXFORD (01) | CT |
U85694 | (02) | CT |