Provider Demographics
NPI:1336386267
Name:ZIEGLER, INNA (PA-C)
Entity type:Individual
Prefix:
First Name:INNA
Middle Name:
Last Name:ZIEGLER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 WATERS PL
Mailing Address - Street 2:SUITE M104
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-2728
Mailing Address - Country:US
Mailing Address - Phone:718-794-1200
Mailing Address - Fax:718-794-1222
Practice Address - Street 1:1615 EASTCHESTER RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-2603
Practice Address - Country:US
Practice Address - Phone:718-892-7700
Practice Address - Fax:718-892-7207
Is Sole Proprietor?:No
Enumeration Date:2009-01-14
Last Update Date:2009-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007016-1363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical