Provider Demographics
NPI:1306051974
Name:ZEMBERA, JILL (RPA-C)
Entity type:Individual
Prefix:MS
First Name:JILL
Middle Name:
Last Name:ZEMBERA
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 MILLERS LN
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-4932
Mailing Address - Country:US
Mailing Address - Phone:718-699-9737
Mailing Address - Fax:718-699-4361
Practice Address - Street 1:9406 59TH AVE STE E-9
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-5151
Practice Address - Country:US
Practice Address - Phone:718-699-9737
Practice Address - Fax:718-699-4361
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2010-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006486363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant