Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | 49534 | WI |
Y | 207RN0300X | Nephrologist | 251087 | NY |
N | 207RN0300X | Nephrologist | 4301114099 | MI |
N | 207RN0300X | Nephrologist | MFC1621 | FL |
NPI | 1629087192 |
---|---|
Provider Name | Mareena Susan Zachariah |
First Address | Troy, MI 48083-1135 |
Second Address | Buffalo, NY 14215-3021 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2006 |
Last Update Date | 14/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03053990 | (05) | NY |
2515398 | INDEPENDENT HEALTH (01) | NY |
2798280000 | (05) | FL |