Provider Demographics
NPI:1497978456
Name:ZAMBITO, PETER EMILIO (MD)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:EMILIO
Last Name:ZAMBITO
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 1:10119 39TH AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CORONA
Mailing Address - State:NY
Mailing Address - Zip Code:11368-4806
Mailing Address - Country:US
Mailing Address - Phone:347-808-8324
Mailing Address - Fax:347-808-8326
Practice Address - Street 1:10119 39TH AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:CORONA
Practice Address - State:NY
Practice Address - Zip Code:11368-4806
Practice Address - Country:US
Practice Address - Phone:347-808-8324
Practice Address - Fax:347-808-8326
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2013-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY232788207RC0001X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02825950Medicaid