Provider Demographics
NPI:1073586962
Name:MIRZA, ZAFAR K (MD)
Entity Type:Individual
Prefix:DR
First Name:ZAFAR
Middle Name:K
Last Name:MIRZA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2223 W STATE ST
Mailing Address - Street 2:SUITE 115
Mailing Address - City:OLEAN
Mailing Address - State:NY
Mailing Address - Zip Code:14760-1938
Mailing Address - Country:US
Mailing Address - Phone:716-372-5601
Mailing Address - Fax:716-372-5616
Practice Address - Street 1:2223 W STATE ST
Practice Address - Street 2:SUITE 115
Practice Address - City:OLEAN
Practice Address - State:NY
Practice Address - Zip Code:14760-1938
Practice Address - Country:US
Practice Address - Phone:716-372-5601
Practice Address - Fax:716-372-5616
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2007-08-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY001683-1207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000526949001OtherBLUE CROSS
NY02341651Medicaid
NY000526949001OtherBLUE CROSS
NYDD3454Medicare ID - Type Unspecified