Provider Demographics
NPI:1306957477
Name:ZHANNA LOGMAN MD PC
Entity type:Organization
Organization Name:ZHANNA LOGMAN MD PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BONNIE
Authorized Official - Middle Name:E
Authorized Official - Last Name:PLAUSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-222-7818
Mailing Address - Street 1:PO BOX 1379
Mailing Address - Street 2:
Mailing Address - City:EAST NORTHPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11731
Mailing Address - Country:US
Mailing Address - Phone:516-222-7818
Mailing Address - Fax:516-222-7816
Practice Address - Street 1:877 STEWART AVENUE
Practice Address - Street 2:SUITE 6
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530
Practice Address - Country:US
Practice Address - Phone:516-222-7818
Practice Address - Fax:516-222-7816
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY212635-1208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWBW551Medicare ID - Type Unspecified
H65552Medicare UPIN