Provider Demographics
NPI:1285028233
Name:ZACHARIAH, JEENA MARY (MD)
Entity Type:Individual
Prefix:DR
First Name:JEENA
Middle Name:MARY
Last Name:ZACHARIAH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 N DUPONT HWY
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:DE
Mailing Address - Zip Code:19720-3135
Mailing Address - Country:US
Mailing Address - Phone:302-328-5150
Mailing Address - Fax:
Practice Address - Street 1:129 N DUPONT HWY
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:DE
Practice Address - Zip Code:19720-3135
Practice Address - Country:US
Practice Address - Phone:302-328-5150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-26
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0012699207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine