Individual
JEFFREY R ZACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 HOSPITAL RD., MARTHA'A VINEYARD HOSPITAL, OAK BLUFFS, MA 02557
(508) 693-0410
Mailing address
PO BOX 1477, OAK BLUFFS, MA 02557-1477
(508) 957-9492
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
213570
MA
207P00000X
Emergency Medicine Physician
MD10339
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007008366
RI MEDICARE
RI
01
—
1578584314
NPI
—
05
—
7008366
—
RI
01
—
MD10339
RI MEDICAL LICENSE
RI
Enumeration date
07/21/2006
Last updated
11/25/2014
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