Provider Demographics
NPI:1407909286
Name:EL-ZAMMAR, ZIAD MK (MD)
Entity Type:Individual
Prefix:
First Name:ZIAD
Middle Name:MK
Last Name:EL-ZAMMAR
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 1:888 E BRIGHTON AVE
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13205-2538
Mailing Address - Country:US
Mailing Address - Phone:315-214-5430
Mailing Address - Fax:315-802-4879
Practice Address - Street 1:888 E BRIGHTON AVE
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13205-2538
Practice Address - Country:US
Practice Address - Phone:315-214-5430
Practice Address - Fax:315-802-4879
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2015-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0029212084N0400X
NY2582392084V0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084V0102XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyVascular Neurology
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02922521Medicaid
NYRB7236Medicare PIN
NYP00460742Medicare PIN