Individual
ZAN MRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 BROOKDALE PLZ RM 178, BROOKLYN, NY 11212-3139
(718) 240-5740
(718) 240-6612
Mailing address
1 BROOKDALE PLZ RM 178, BROOKLYN, NY 11212-3139
(718) 240-5740
(718) 240-6612
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
183223
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00246075
—
NY
Enumeration date
11/17/2006
Last updated
03/17/2018
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