Provider Demographics
NPI:1376510669
Name:PELKEY, ZINAIDA (DO)
Entity type:Individual
Prefix:DR
First Name:ZINAIDA
Middle Name:
Last Name:PELKEY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 W 96TH ST
Mailing Address - Street 2:#A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-6556
Mailing Address - Country:US
Mailing Address - Phone:212-662-6560
Mailing Address - Fax:212-662-6538
Practice Address - Street 1:32 W 96TH ST
Practice Address - Street 2:#A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-6556
Practice Address - Country:US
Practice Address - Phone:212-662-6560
Practice Address - Fax:212-662-6538
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-05
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY194252-1204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02I541Medicare ID - Type UnspecifiedPROVIDER #
NYF70482Medicare UPIN