Individual
JONATHAN ZAGZAG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2200 NORTHERN BLVD, GREENVALE, NY 11548-1219
(516) 627-5262
Mailing address
2200 NORTHERN BLVD, GREENVALE, NY 11548-1219
(516) 627-5262
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
R3251
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
375462401
—
TX
05
—
375462402
—
TX
Enumeration date
01/10/2011
Last updated
04/24/2025
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