Provider Demographics
NPI:1386195451
Name:MAMMO, ZAID (MD)
Entity Type:Individual
Prefix:MR
First Name:ZAID
Middle Name:
Last Name:MAMMO
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 1:635 WEST 165TH STREET
Mailing Address - Street 2:SUITE 218
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032
Mailing Address - Country:US
Mailing Address - Phone:212-305-2725
Mailing Address - Fax:212-305-5962
Practice Address - Street 1:635 WEST 165TH STREET
Practice Address - Street 2:SUITE 218
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032
Practice Address - Country:US
Practice Address - Phone:212-305-2725
Practice Address - Fax:212-305-5962
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-24
Last Update Date:2017-10-24
Deactivation Date:2017-09-21
Deactivation Code:
Reactivation Date:2017-10-24
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program