Provider Demographics
NPI:1851392138
Name:ZAKY, SAMIR F
Entity Type:Individual
Prefix:DR
First Name:SAMIR
Middle Name:F
Last Name:ZAKY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2A TOPSTONE DR
Mailing Address - Street 2:
Mailing Address - City:BETHEL
Mailing Address - State:CT
Mailing Address - Zip Code:06801-2624
Mailing Address - Country:US
Mailing Address - Phone:203-942-9141
Mailing Address - Fax:
Practice Address - Street 1:2A TOPSTONE DR
Practice Address - Street 2:
Practice Address - City:BETHEL
Practice Address - State:CT
Practice Address - Zip Code:06801-2624
Practice Address - Country:US
Practice Address - Phone:203-942-9141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000749213E00000X, 213ES0131X, 213EP1101X, 213EP0504X, 213ER0200X, 213ES0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213EP0504XPodiatric Medicine & Surgery Service ProvidersPodiatristPublic Medicine
No213ER0200XPodiatric Medicine & Surgery Service ProvidersPodiatristRadiology
No213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT4702850001OtherDEMRC
CTP00058892OtherRAILROAD MEDICARE
CTP2630726OtherOXFORD
CT030000749CT02OtherBC/BS AND BLUE CARE
CT9577804OtherCIGNA
CT030000749CT02OtherBC/BS AND BLUE CARE