Provider Demographics
NPI:1477716819
Name:ZAKARIA, KHURRAM SHAHZAD (MD)
Entity Type:Individual
Prefix:DR
First Name:KHURRAM
Middle Name:SHAHZAD
Last Name:ZAKARIA
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 1:72 PARKVIEW DR
Mailing Address - Street 2:
Mailing Address - City:ALBERTSON
Mailing Address - State:NY
Mailing Address - Zip Code:11507-1037
Mailing Address - Country:US
Mailing Address - Phone:718-554-6630
Mailing Address - Fax:
Practice Address - Street 1:72 PARKVIEW DR
Practice Address - Street 2:
Practice Address - City:ALBERTSON
Practice Address - State:NY
Practice Address - Zip Code:11507-1037
Practice Address - Country:US
Practice Address - Phone:718-554-6630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-07
Last Update Date:2017-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY249364207R00000X, 208M00000X
IL036142660208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL214881OtherMEDICARE GROUP PTAN