Provider Demographics
NPI:1275167793
Name:ZELDIN, ALEXANDER (OD)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:
Last Name:ZELDIN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2132 E 13TH ST APT 1R
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-4311
Mailing Address - Country:US
Mailing Address - Phone:917-613-9141
Mailing Address - Fax:
Practice Address - Street 1:103 QUENTIN RD STE G1-1
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-1173
Practice Address - Country:US
Practice Address - Phone:718-645-2201
Practice Address - Fax:718-645-2207
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-24
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV009107152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist