Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 279819 | NY |
N | 111NI0900X | Internist | 279819 | NY |
Y | 207RI0200X | Infectious Disease | 279819 | NY |
N | 208000000X | Pediatrician | 279819 | NY |
N | 2080P0208X | Pediatric Infectious Diseases | 279819 | NY |
NPI | 1306162995 |
---|---|
Provider Name | Jason E Zucker |
First Address | New York, NY 10032-3725 |
Second Address | New York, NY 10032-3733 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2010 |
Last Update Date | 09/12/2021 |