Provider Demographics
NPI:1093389397
Name:SEAFORTH, ZOYA
Entity Type:Individual
Prefix:
First Name:ZOYA
Middle Name:
Last Name:SEAFORTH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:228 E 45TH ST # GF32
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-3303
Mailing Address - Country:US
Mailing Address - Phone:646-342-6272
Mailing Address - Fax:
Practice Address - Street 1:71 MONARCH CIR
Practice Address - Street 2:
Practice Address - City:BASKING RIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07920-3146
Practice Address - Country:US
Practice Address - Phone:646-342-6272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-20
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY34120601164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse