Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 213284 | NY |
N | 207N00000X | Dermatologist | 48274 | AZ |
N | 207ND0101X | MOHS-Micrographic Surgeon | 48274 | AZ |
N | 207NS0135X | Procedural Dermatology | 48274 | AZ |
NPI | 1164403010 |
---|---|
Provider Name | Nathalie Zeitouni |
First Address | Phoenix, AZ 85004-2155 |
Second Address | Phoenix, AZ 85004-2155 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2005 |
Last Update Date | 15/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01934734 | (05) | NY |
G57744 | (02) | NY |