Provider Demographics
NPI:1033186341
Name:ZENS, ALBERT L (MD)
Entity Type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:L
Last Name:ZENS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:19475 N GRAYHAWK DR
Mailing Address - Street 2:#1024
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-7414
Mailing Address - Country:US
Mailing Address - Phone:315-380-8887
Mailing Address - Fax:
Practice Address - Street 1:19475 N GRAYHAWK DR
Practice Address - Street 2:#1024
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-7414
Practice Address - Country:US
Practice Address - Phone:315-380-8887
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-06
Last Update Date:2015-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1280582085R0202X, 207U00000X
AZ32394207U00000X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00420622Medicaid
NY00420622Medicaid
NY00420622Medicaid