Provider Demographics
NPI:1982973731
Name:BOWEN, ZAKIA DELE (MD)
Entity Type:Individual
Prefix:
First Name:ZAKIA
Middle Name:DELE
Last Name:BOWEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 LYONS AVE
Mailing Address - Street 2:A6-HOSPITALIST OFFICE
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07112-2027
Mailing Address - Country:US
Mailing Address - Phone:973-926-2164
Mailing Address - Fax:973-391-8524
Practice Address - Street 1:201 LYONS AVENUE
Practice Address - Street 2:A6-HOSPITALIST OFFICE
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07003
Practice Address - Country:US
Practice Address - Phone:973-926-2164
Practice Address - Fax:973-391-8524
Is Sole Proprietor?:No
Enumeration Date:2011-12-23
Last Update Date:2018-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09944000207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program