Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | NOO3037 | NY |
Y | 222Z00000X | Podiatrist | NOO3037 | NY |
N | 213EP1101X | Primary Podiatric Medicine | N003037 | NY |
N | 213ES0131X | Foot Surgery | N003037 | NY |
NPI | 1467414896 |
---|---|
Provider Name | Dr. Simon Muaka Nzuzi |
First Address | Rosedale, NY 11422-1047 |
Second Address | Hollis, NY 11423-2220 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2006 |
Last Update Date | 03/08/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
#0276134 | CIGNA-MEDICARE (01) | NY |
0029644 P-64 P110 | OXFORD PLANS (01) | NY |
0046447 | GHI PROVIDER NUMBER (01) | NY |
0047963 | (05) | NY |
115, 119, 65 | FIDELIS (01) | NY |
396200P | HIP PROVIDER NUMBER (01) | NY |
MPI:28980 | UNITED HEALTH PLANS (01) | NY |
P.3037-0 | WORKER-COMPENSATION (01) | NY |
P34003SN | BLEU CROSS/BLEU SHIELD (01) | NY |
SP13669 | CENTER CARE PROVIDER NUMB (01) | NY |
T311940 | (02) | NY |