Basic Information
Provider Information | |||||||||
NPI: | 1407935976 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | ZEFT | ||||||||
FirstName: | ANDREW | ||||||||
MiddleName: | SAMUEL | ||||||||
NamePrefix: | DR. | ||||||||
NameSuffix: |   | ||||||||
Credential: | MD, MPH | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: | ZEFT | ||||||||
OtherFirstName: | ANDREW | ||||||||
OtherMiddleName: | S | ||||||||
OtherNamePrefix: | DR. | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: | MD, MPH | ||||||||
OtherLastNameType: | 2 | ||||||||
Mailing Information | |||||||||
Address1: | 9500 EUCLID AVE # R3 | ||||||||
Address2: |   | ||||||||
City: | CLEVELAND | ||||||||
State: | OH | ||||||||
PostalCode: | 441951100 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 2164445801 | ||||||||
FaxNumber: | 2164425103 | ||||||||
Practice Location | |||||||||
Address1: | 9500 EUCLID AVE # R3 | ||||||||
Address2: |   | ||||||||
City: | CLEVELAND | ||||||||
State: | OH | ||||||||
PostalCode: | 441951103 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 2164445801 | ||||||||
FaxNumber: | 2164425103 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 11/03/2006 | ||||||||
LastUpdateDate: | 03/14/2019 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | M | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 6006263-1205 | UT | N |   | Allopathic & Osteopathic Physicians | Pediatrics |   | 2080P0216X | 096621 | OH | Y |   | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Rheumatology |
No ID Information.