Provider Demographics
NPI:1285671057
Name:SHEREMETA, PAUL ZONI (DPM)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:ZONI
Last Name:SHEREMETA
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3761 CARMAN RD
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12303-5418
Mailing Address - Country:US
Mailing Address - Phone:518-688-1774
Mailing Address - Fax:518-688-1776
Practice Address - Street 1:3761 CARMAN RD
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12303-5418
Practice Address - Country:US
Practice Address - Phone:518-688-1774
Practice Address - Fax:518-688-1776
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-01
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN004984213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01653263Medicaid
NY53537BMedicare PIN
NY1473120001Medicare NSC
NY01653263Medicaid