Provider Demographics
NPI:1073799474
Name:ZELLNER OPHTHALMOLOGY, LLC
Entity Type:Organization
Organization Name:ZELLNER OPHTHALMOLOGY, LLC
Other - Org Name:JAMES H ZELLNER, M.D., P.C.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:H
Authorized Official - Last Name:ZELLNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-748-2020
Mailing Address - Street 1:7817 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-3703
Mailing Address - Country:US
Mailing Address - Phone:718-748-2020
Mailing Address - Fax:
Practice Address - Street 1:7817 5TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-3703
Practice Address - Country:US
Practice Address - Phone:718-748-2020
Practice Address - Fax:718-748-0663
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-15
Last Update Date:2008-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY135043207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00579180Medicaid
NYA62682Medicare UPIN
NY42A631Medicare PIN