Provider Demographics
NPI:1265447049
Name:PAUL T ZAYDON,MD
Entity Type:Organization
Organization Name:PAUL T ZAYDON,MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:T
Authorized Official - Last Name:ZAYDON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:401-723-4290
Mailing Address - Street 1:115 NEWPORT AVE
Mailing Address - Street 2:
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02861-4107
Mailing Address - Country:US
Mailing Address - Phone:401-723-4290
Mailing Address - Fax:401-723-4830
Practice Address - Street 1:115 NEWPORT AVE
Practice Address - Street 2:
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02861-4107
Practice Address - Country:US
Practice Address - Phone:401-723-4290
Practice Address - Fax:401-723-4830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty