Provider Demographics
NPI:1669044541
Name:ZAKEY, POLA
Entity type:Individual
Prefix:
First Name:POLA
Middle Name:
Last Name:ZAKEY
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 1:7803 67TH RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLE VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11379-2842
Mailing Address - Country:US
Mailing Address - Phone:803-487-9348
Mailing Address - Fax:
Practice Address - Street 1:7803 67TH RD
Practice Address - Street 2:
Practice Address - City:MIDDLE VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11379-2842
Practice Address - Country:US
Practice Address - Phone:803-487-9348
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-12
Last Update Date:2021-11-15
Deactivation Date:2021-07-15
Deactivation Code:
Reactivation Date:2021-11-15
Provider Licenses
StateLicense IDTaxonomies
NY047273-01225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist