Provider Demographics
NPI:1285813881
Name:ZIA, SYED ARIF (MD)
Entity Type:Individual
Prefix:
First Name:SYED
Middle Name:ARIF
Last Name:ZIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 783311
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-3311
Mailing Address - Country:US
Mailing Address - Phone:484-884-0661
Mailing Address - Fax:484-884-0628
Practice Address - Street 1:120 BURRUS BLVD
Practice Address - Street 2:
Practice Address - City:BRODHEADSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18322-7812
Practice Address - Country:US
Practice Address - Phone:570-420-6300
Practice Address - Fax:570-402-2920
Is Sole Proprietor?:No
Enumeration Date:2007-10-31
Last Update Date:2018-09-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD440441207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA194320YEBKMedicare PIN
PA194320YUNMMedicare PIN