Provider Demographics
NPI:1578754404
Name:ZADRIMA, ANA (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:MRS
First Name:ANA
Middle Name:
Last Name:ZADRIMA
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1448 KENNELLWORTH PL
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10465-1241
Mailing Address - Country:US
Mailing Address - Phone:917-407-6831
Mailing Address - Fax:
Practice Address - Street 1:1448 KENNELLWORTH PL
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10465-1241
Practice Address - Country:US
Practice Address - Phone:917-407-6831
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-06
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011984363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant