Dora Zaretsky, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

213276 Issued in NY

Practice address

7136 110TH St
Ste 1H
Forest Hills, NY 11375-4850

Phone

(718) 938-8478

Fax

(718) 997-1290

NPI assigned

Sep 17, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Revived Soul Medical PC

  • Psychiatry Physician
  • Brooklyn, NY
  • NPI 1821389941
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276732800000",
    "number": "1013014661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 750811",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113750811",
            "telephone_number": "718-938-8478",
            "fax_number": "718-997-1290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7136 110TH ST",
            "address_2": "STE 1H",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113754850",
            "telephone_number": "718-938-8478",
            "fax_number": "718-997-1290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZARETSKY",
        "first_name": "DORA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-17",
        "last_updated": "2010-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "213276",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01983086",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yulia Zakaryan
• Rachel Zakhary, PA-C
• Reah Amelia Zaman
• Maria Zapantis, M.D.
• Samir Mohamed Hanafy Zaqdan, DPT
• Klaudia Katarzyna Zargarov
• Joseph Zarowin, MD
• Sarah Schofield Zatlin, LMSW
• Pina del Carmen Zavaleta Beltran
• Susanna Zavlanova

• Psychiatry Physician in Forest Hills, NY
• Providers in Forest Hills, NY by specialty
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.