Provider Demographics
NPI:1568713014
Name:NORTH SHORE PRIMARY CARE P.C.
Entity Type:Organization
Organization Name:NORTH SHORE PRIMARY CARE P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MUZAFFAR
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:631-807-2477
Mailing Address - Street 1:88 CEDAR RD
Mailing Address - Street 2:
Mailing Address - City:EAST NORTHPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11731-4131
Mailing Address - Country:US
Mailing Address - Phone:631-807-2477
Mailing Address - Fax:877-717-1721
Practice Address - Street 1:12415 JAMAICA AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11418-2649
Practice Address - Country:US
Practice Address - Phone:718-480-6626
Practice Address - Fax:718-480-6621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-24
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY261963207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty