Provider Demographics
NPI:1437195427
Name:ZAFFER, IMRAN (MD)
Entity Type:Individual
Prefix:DR
First Name:IMRAN
Middle Name:
Last Name:ZAFFER
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 1:755 PARK AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-3975
Mailing Address - Country:US
Mailing Address - Phone:631-683-4235
Mailing Address - Fax:631-683-4238
Practice Address - Street 1:755 PARK AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-3975
Practice Address - Country:US
Practice Address - Phone:631-683-4235
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-20
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0017972207RG0100X
NY244910207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02553217Medicaid
NY244910OtherLICENSE
NY244910OtherLICENSE
NY02553217Medicaid