Provider Demographics
NPI:1457924474
Name:ZERGHAM, AZKA SHAHID (MD)
Entity type:Individual
Prefix:DR
First Name:AZKA
Middle Name:SHAHID
Last Name:ZERGHAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:AZKA
Other - Middle Name:
Other - Last Name:SHAHID
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1301 TRUMANSBURG RD STE P
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-1397
Mailing Address - Country:US
Mailing Address - Phone:914-608-1806
Mailing Address - Fax:
Practice Address - Street 1:40 CATHERWOOD RD
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-1056
Practice Address - Country:US
Practice Address - Phone:914-608-1806
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-19
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY334067-01207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine