Basic Information
| Provider Information | |||||||||
| NPI: | 1679120679 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ZABERTO | ||||||||
| FirstName: | KARIN | ||||||||
| MiddleName: | |||||||||
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| OtherLastName: | MERRINS | ||||||||
| OtherFirstName: | KARIN | ||||||||
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| OtherCredential: | NP | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 23 MCKAY RD | ||||||||
| Address2: | |||||||||
| City: | HUNTINGTON STATION | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117461316 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5168608257 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 635 BELLE TERRE RD STE 209 | ||||||||
| Address2: | |||||||||
| City: | PORT JEFFERSON | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117771987 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6314740707 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/23/2019 | ||||||||
| LastUpdateDate: | 10/06/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/06/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2200X | 309205 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
No ID Information.