Provider Demographics
NPI:1952024341
Name:ZAJA, AUBREY DARE (PA-C)
Entity Type:Individual
Prefix:
First Name:AUBREY
Middle Name:DARE
Last Name:ZAJA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:AUBREY
Other - Middle Name:DARE
Other - Last Name:JILES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:22 KEVAN CIR
Mailing Address - Street 2:
Mailing Address - City:MANLIUS
Mailing Address - State:NY
Mailing Address - Zip Code:13104-1018
Mailing Address - Country:US
Mailing Address - Phone:315-380-0506
Mailing Address - Fax:
Practice Address - Street 1:736 IRVING AVE
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-1602
Practice Address - Country:US
Practice Address - Phone:315-470-7111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-21
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant