Provider Demographics
NPI:1891817953
Name:ZEB, SHAHZAD (RPA-C)
Entity Type:Individual
Prefix:
First Name:SHAHZAD
Middle Name:
Last Name:ZEB
Suffix:
Gender:M
Credentials:RPA-C
Other - Prefix:
Other - First Name:SHAZAD
Other - Middle Name:
Other - Last Name:ZEB
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPA-C
Mailing Address - Street 1:101 HOSPITAL RD
Mailing Address - Street 2:
Mailing Address - City:PATCHOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11772-4870
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:450 WAVERLY AVE
Practice Address - Street 2:
Practice Address - City:PATCHOGUE
Practice Address - State:NY
Practice Address - Zip Code:11772-1555
Practice Address - Country:US
Practice Address - Phone:631-204-6288
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011766-1363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant