Provider Demographics
NPI:1437145968
Name:ZAK, EUGENE (MD)
Entity Type:Individual
Prefix:
First Name:EUGENE
Middle Name:
Last Name:ZAK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:YVEGENY
Other - Middle Name:
Other - Last Name:ZAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:289 PLEASANT ST
Mailing Address - Street 2:SUITE 402
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02721-3005
Mailing Address - Country:US
Mailing Address - Phone:508-679-1906
Mailing Address - Fax:508-673-6630
Practice Address - Street 1:289 PLEASANT ST
Practice Address - Street 2:SUITE 402
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02721-3005
Practice Address - Country:US
Practice Address - Phone:508-679-1906
Practice Address - Fax:508-673-6630
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-20
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA80765207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F66859Medicare UPIN
ZAJ16007Medicare PIN