Provider Demographics
NPI:1467453076
Name:BEN-ARI, ZINA (MD)
Entity Type:Individual
Prefix:
First Name:ZINA
Middle Name:
Last Name:BEN-ARI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6389 SAUNDERS ST STE BA3
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-3142
Mailing Address - Country:US
Mailing Address - Phone:718-897-2525
Mailing Address - Fax:718-897-1125
Practice Address - Street 1:6389 SAUNDERS ST
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-3142
Practice Address - Country:US
Practice Address - Phone:718-897-2525
Practice Address - Fax:718-897-1125
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-04
Last Update Date:2010-12-20
Deactivation Date:2006-03-22
Deactivation Code:
Reactivation Date:2006-04-07
Provider Licenses
StateLicense IDTaxonomies
NY182520207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01617683Medicaid
NY01617683Medicaid
69734Medicare ID - Type Unspecified