Provider Demographics
NPI:1033736467
Name:ZAHOOR, SIDRA MALIK (DDS)
Entity Type:Individual
Prefix:
First Name:SIDRA
Middle Name:MALIK
Last Name:ZAHOOR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1712 ONEIDA ST
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13501-5719
Mailing Address - Country:US
Mailing Address - Phone:607-259-3300
Mailing Address - Fax:
Practice Address - Street 1:1712 ONEIDA ST
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13501-5719
Practice Address - Country:US
Practice Address - Phone:607-259-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-01
Last Update Date:2020-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1326267378Medicaid