Provider Demographics
NPI:1366884348
Name:SAGGINARIO, ZENA RIYADH (PA-C)
Entity type:Individual
Prefix:
First Name:ZENA
Middle Name:RIYADH
Last Name:SAGGINARIO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ZENA
Other - Middle Name:RIYADH
Other - Last Name:YALDO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:5340 FOX RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-2010
Mailing Address - Country:US
Mailing Address - Phone:248-231-3721
Mailing Address - Fax:
Practice Address - Street 1:5340 FOX RIDGE DR
Practice Address - Street 2:
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322-2010
Practice Address - Country:US
Practice Address - Phone:248-231-3721
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-19
Last Update Date:2017-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016575-1363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant