Basic Information
Provider Information
NPI: 1073956983
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: JONES
FirstName: ZACHARY
MiddleName: ALLYN
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 33 LEWIS RD
Address2: 2ND FL
City: BINGHAMTON
State: NY
PostalCode: 13905
CountryCode: US
TelephoneNumber: 6077298156
FaxNumber:  
Practice Location
Address1: 33-57 HARRISON ST
Address2:  
City: JOHNSON CITY
State: NY
PostalCode: 13790
CountryCode: US
TelephoneNumber: 6077636622
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/10/2013
LastUpdateDate: 06/01/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RI0200X290601NYN Allopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
207R00000X290601NYY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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