Provider Demographics
NPI:1578558037
Name:ZINKIN, HEATHER D (MD)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:D
Last Name:ZINKIN
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 1:16 CURRIER AVE
Mailing Address - Street 2:
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-8125
Mailing Address - Country:US
Mailing Address - Phone:631-470-2010
Mailing Address - Fax:
Practice Address - Street 1:989 JERICHO TURNKPIKE
Practice Address - Street 2:
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787
Practice Address - Country:US
Practice Address - Phone:631-864-5600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-12
Last Update Date:2009-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2129172085R0001X
NY239245-12085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAI37147Medicare UPIN
MAA38943Medicare ID - Type Unspecified