# IRENE ZIDE MD

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1750718607
- **Authorized official:** IRENE ZIDE MD (OWNER)
- **Authorized official phone:** (516) 371-0517

## Contact information

- **Practice address:** 290 CENTRAL AVE, SUITE 202, LAWRENCE, NY 11559-8507
- **Practice address phone:** (516) 371-0517
- **Practice address fax:** (516) 371-0519
- **Mailing address:** 290 CENTRAL AVE, SUITE 202, LAWRENCE, NY 11559-8507
- **Mailing address phone:** (516) 371-0517
- **Mailing address fax:** (516) 371-0519

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | 151719 | NY | Yes |

## Other

- **Enumeration date:** 10/07/2013
- **Last updated:** 10/07/2013