Provider Demographics
NPI:1033655378
Name:EL-SAMIN, ZACHARIA (PAC)
Entity Type:Individual
Prefix:MR
First Name:ZACHARIA
Middle Name:
Last Name:EL-SAMIN
Suffix:
Gender:M
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 PINE TREE TER
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:CT
Mailing Address - Zip Code:06234-3324
Mailing Address - Country:US
Mailing Address - Phone:860-208-6620
Mailing Address - Fax:
Practice Address - Street 1:21 PINE TREE TER
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:CT
Practice Address - Zip Code:06234-3324
Practice Address - Country:US
Practice Address - Phone:860-208-6620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-10
Last Update Date:2017-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical