Basic Information
| Provider Information | |||||||||
| NPI: | 1053490045 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ZAMAN | ||||||||
| FirstName: | SYED | ||||||||
| MiddleName: | N | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 104 UNION AVE STE 1005 | ||||||||
| Address2: | ST JOSEPHS MEDICAL OFFICE CENTER | ||||||||
| City: | SYRACUSE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 132032761 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3154240790 | ||||||||
| FaxNumber: | 3154750916 | ||||||||
| Practice Location | |||||||||
| Address1: | 104 UNION AVE. | ||||||||
| Address2: | SUITE 1005 | ||||||||
| City: | SYRACUSE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 132032761 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3154240790 | ||||||||
| FaxNumber: | 3154750916 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/02/2006 | ||||||||
| LastUpdateDate: | 07/18/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2086S0129X | 1202841 | NY | Y | Allopathic & Osteopathic Physicians | Surgery | Vascular Surgery |
ID Information
| ID | Type | State | Issuer | Description | 00Y79149 | 05 | NY | MEDICAID |