Provider Demographics
NPI:1881875557
Name:ZABRISKIE, BEVERLY (PA-C)
Entity type:Individual
Prefix:
First Name:BEVERLY
Middle Name:
Last Name:ZABRISKIE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3433 DEKALB AVE
Mailing Address - Street 2:APT 4 H
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-2311
Mailing Address - Country:US
Mailing Address - Phone:718-790-6910
Mailing Address - Fax:
Practice Address - Street 1:MONTEFIORE MEDICAL CENTER
Practice Address - Street 2:111 E 210TH ST
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467
Practice Address - Country:US
Practice Address - Phone:718-920-6016
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-21
Last Update Date:2007-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005395363A00000X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical