Provider Demographics
NPI:1760519151
Name:ZAIRIS, IGNATIOS S (MD)
Entity Type:Individual
Prefix:DR
First Name:IGNATIOS
Middle Name:S
Last Name:ZAIRIS
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:PO BOX 8560
Mailing Address - Street 2:
Mailing Address - City:WOODCLIFF LAKE
Mailing Address - State:NJ
Mailing Address - Zip Code:07677-8560
Mailing Address - Country:US
Mailing Address - Phone:201-837-8282
Mailing Address - Fax:201-837-0010
Practice Address - Street 1:718 TEANECK ROAD
Practice Address - Street 2:HOLY NAME REGIONAL CANCER CENTER L1
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-4243
Practice Address - Country:US
Practice Address - Phone:201-837-8282
Practice Address - Fax:201-837-0010
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04391400208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3308804Medicaid
NJ446065Medicare ID - Type Unspecified
C54791Medicare UPIN