Provider Demographics
NPI:1598862237
Name:ZACHAROFF, KEVIN LLOYD (MD)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:LLOYD
Last Name:ZACHAROFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:KEVIN
Other - Middle Name:LLOYD
Other - Last Name:ZACHAROFF
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1 FLAX POND WOODS RD
Mailing Address - Street 2:
Mailing Address - City:SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733-1623
Mailing Address - Country:US
Mailing Address - Phone:631-941-3540
Mailing Address - Fax:631-941-3540
Practice Address - Street 1:1 FLAX POND WOODS RD
Practice Address - Street 2:
Practice Address - City:SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-1623
Practice Address - Country:US
Practice Address - Phone:631-941-3540
Practice Address - Fax:631-941-3540
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY162379207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology