Provider Demographics
NPI:1154574606
Name:ZAKHALEVA, JULIA (MD)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:ZAKHALEVA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:322 E MAIN ST
Mailing Address - Street 2:SUITE 1B
Mailing Address - City:BRANFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06405-3136
Mailing Address - Country:US
Mailing Address - Phone:203-488-7228
Mailing Address - Fax:203-488-7227
Practice Address - Street 1:2200 WHITNEY AVE
Practice Address - Street 2:SUITE 220
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06518-3691
Practice Address - Country:US
Practice Address - Phone:203-281-7000
Practice Address - Fax:203-281-9300
Is Sole Proprietor?:No
Enumeration Date:2008-10-28
Last Update Date:2017-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT54138208600000X, 208C00000X
FLME 112785208600000X
FLME112785390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program