1124099148 NPI number — DR. KALMAN ZABIROWICZ O.D.

Table of content: DR. KALMAN ZABIROWICZ O.D. (NPI 1124099148)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124099148 NPI number — DR. KALMAN ZABIROWICZ O.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ZABIROWICZ
Provider First Name:
KALMAN
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
O.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1124099148
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/13/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
369 E MAIN ST
Provider Second Line Business Mailing Address:
SUITE 6
Provider Business Mailing Address City Name:
EAST ISLIP
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11730-2800
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
631-224-4834
Provider Business Mailing Address Fax Number:
631-277-7325

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
369 E MAIN ST
Provider Second Line Business Practice Location Address:
SUITE 6
Provider Business Practice Location Address City Name:
EAST ISLIP
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11730-2800
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
631-224-4834
Provider Business Practice Location Address Fax Number:
631-277-7325
Provider Enumeration Date:
01/28/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  VUT-003811 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 412167012 . This is a "VISION SERVICE PLAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 3795886 . This is a "AETNA PROVIDER NUMBER" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 50499 . This is a "DAVIS VISION PROVIDER NO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: KZ0C411H10 . This is a "EMPIRE BC BS PIN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 3213843 . This is a "CIGNA PPO OAP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: P00253979 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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