Provider Demographics
NPI:1386609238
Name:ZEMA, MICHAEL J (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:J
Last Name:ZEMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 766
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:NY
Mailing Address - Zip Code:11763-0766
Mailing Address - Country:US
Mailing Address - Phone:631-736-3161
Mailing Address - Fax:631-698-1794
Practice Address - Street 1:844 GOLF LN
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:NY
Practice Address - Zip Code:11763-1203
Practice Address - Country:US
Practice Address - Phone:631-736-3161
Practice Address - Fax:631-698-1794
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY126029207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00661734Medicaid
C08446Medicare UPIN
321791Medicare ID - Type Unspecified