Provider Demographics
NPI:1922552181
Name:ZIA, BUSHRA (MD)
Entity Type:Individual
Prefix:
First Name:BUSHRA
Middle Name:
Last Name:ZIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:262 NEW LUDLOW RD
Mailing Address - Street 2:
Mailing Address - City:CHICOPEE
Mailing Address - State:MA
Mailing Address - Zip Code:01020-4324
Mailing Address - Country:US
Mailing Address - Phone:413-535-4714
Mailing Address - Fax:413-535-4716
Practice Address - Street 1:11 HOSPITAL DR FL 3
Practice Address - Street 2:
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040-6601
Practice Address - Country:US
Practice Address - Phone:413-540-5048
Practice Address - Fax:413-540-5049
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-05
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA291000207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty