1801881081 NPI number — DAVID ZUCKERBERG MD

Table of content: DAVID ZUCKERBERG MD (NPI 1801881081)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801881081 NPI number — DAVID ZUCKERBERG MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ZUCKERBERG
Provider First Name:
DAVID
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
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:
1801881081
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/02/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5 LONG POND RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WACCABUC
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10597-1014
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
914-763-9616
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
GRASSLANDS RD
Provider Second Line Business Practice Location Address:
WESTCHESTER MEDICAL CENTER
Provider Business Practice Location Address City Name:
VALHALLA
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10595
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
914-493-7656
Provider Business Practice Location Address Fax Number:
914-493-8261
Provider Enumeration Date:
09/14/2005

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: 207P00000X , with the licence number:  190698 , 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: 061009000084 . This is a "FIDELIS CARE OF NY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 5C7520 . This is a "HEALTHNET PIN #" identifier . This identifiers is of the category "OTHER".
  • Identifier: P2830825 . This is a "OXFORD HEALTH PIN#" identifier . This identifiers is of the category "OTHER".
  • Identifier: 4147748 . This is a "MVP HEALTHPLAN PIN#" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1526Q1 . This is a "EMPIRE BC BS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000000109857 . This is a "GHI HMO PIN #" identifier . This identifiers is of the category "OTHER".
  • Identifier: 10039781 . This is a "CDPHP PIN #" identifier . This identifiers is of the category "OTHER".
  • Identifier: 01488564 . This is a "GHI PPO PIN #" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7152520 . This is a "AETNA PPO PIN#" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1082120 . This is a "AETNA HMO PIN #" identifier . This identifiers is of the category "OTHER".




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