Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | NYS194761 | NY |
NPI | 1013010107 |
---|---|
Provider Name | John Robert Zaso |
First Address | East Meadow, NY 11554 |
Second Address | East Meadow, NY 11554 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/09/2006 |
Last Update Date | 08/07/2007 |