Provider Demographics
NPI:1164695334
Name:ZAPATA, GERARDO CARLOS (MD)
Entity Type:Individual
Prefix:DR
First Name:GERARDO
Middle Name:CARLOS
Last Name:ZAPATA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 68TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-5201
Mailing Address - Country:US
Mailing Address - Phone:718-833-6633
Mailing Address - Fax:718-238-4748
Practice Address - Street 1:260 68TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-5201
Practice Address - Country:US
Practice Address - Phone:718-833-6633
Practice Address - Fax:718-238-4748
Is Sole Proprietor?:No
Enumeration Date:2008-04-09
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY094090-1208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYZGO10F8510Medicare PIN
NYD92282Medicare UPIN