Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | MD.206938 | LA |
NPI | 1013206416 |
---|---|
Provider Name | Zachary Paul Funk |
First Address | Brooklyn, NY 11219-2916 |
Second Address | Brooklyn, NY 11219-2916 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2011 |
Last Update Date | 01/07/2014 |