Provider Demographics
NPI:1386831832
Name:ZAK, SVETLANA (MHNP-BC)
Entity type:Individual
Prefix:MRS
First Name:SVETLANA
Middle Name:
Last Name:ZAK
Suffix:
Gender:F
Credentials:MHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 ROGERS AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-4831
Mailing Address - Country:US
Mailing Address - Phone:516-350-2797
Mailing Address - Fax:980-495-8942
Practice Address - Street 1:16 ROGERS AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-4831
Practice Address - Country:US
Practice Address - Phone:516-350-2797
Practice Address - Fax:980-495-8942
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-28
Last Update Date:2021-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP2845363LP0808X
NYF401686-01363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty