Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | 125698 | NY |
NPI | 1164457628 |
---|---|
Provider Name | Alan P Zeitlin |
First Address | Forest Hills, NY 11375-4323 |
Second Address | Forest Hills, NY 11375-4323 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00500647 | (05) | NY |
B11353 | (02) |