Provider Demographics
NPI:1063016343
Name:ZAYATS, ARTEM
Entity Type:Individual
Prefix:
First Name:ARTEM
Middle Name:
Last Name:ZAYATS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 E 95TH ST APT 28D
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-4074
Mailing Address - Country:US
Mailing Address - Phone:347-573-3646
Mailing Address - Fax:
Practice Address - Street 1:205 E 95TH ST APT 28D
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-4074
Practice Address - Country:US
Practice Address - Phone:347-573-3646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-26
Last Update Date:2020-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028106225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist