Provider Demographics
NPI:1144227414
Name:ZIRATH, MONIKA (NP)
Entity Type:Individual
Prefix:
First Name:MONIKA
Middle Name:
Last Name:ZIRATH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 E ADAMS ST
Mailing Address - Street 2:REGIONAL ONCOLOGY CENTER
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210-2342
Mailing Address - Country:US
Mailing Address - Phone:315-464-8200
Mailing Address - Fax:315-464-8206
Practice Address - Street 1:750 E ADAMS ST
Practice Address - Street 2:REGIONAL ONCOLOGY CENTER
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-2342
Practice Address - Country:US
Practice Address - Phone:315-464-8200
Practice Address - Fax:315-464-8206
Is Sole Proprietor?:No
Enumeration Date:2005-07-01
Last Update Date:2013-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF333375363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02508336Medicaid
NYJ400065955Medicare PIN
NY02508336Medicaid