Provider Demographics
NPI:1033165774
Name:ZAKHEIM, ALAN R (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:R
Last Name:ZAKHEIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:252 7TH AVE
Mailing Address - Street 2:15G
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-7326
Mailing Address - Country:US
Mailing Address - Phone:516-562-6518
Mailing Address - Fax:646-895-7662
Practice Address - Street 1:100 PORT WASHINGTON BLVD
Practice Address - Street 2:DEPT. OF RADIOLOGY
Practice Address - City:ROSLYN
Practice Address - State:NY
Practice Address - Zip Code:11576-1353
Practice Address - Country:US
Practice Address - Phone:516-562-6518
Practice Address - Fax:646-895-7662
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME 950152085R0202X, 2085R0204X
NJ722982085R0204X, 2085R0202X
NY2042372085R0204X, 2085R0202X
NJ25MA072298002085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H43939Medicare UPIN