Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 141838 | NY |
NPI | 1023002060 |
---|---|
Provider Name | Zvi Zisbrod |
First Address | Brooklyn, NY 11223-3858 |
Second Address | Brooklyn, NY 11223-3858 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/09/2005 |
Last Update Date | 13/04/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00812771 | (05) | NY |
B01472 | (02) |