Provider Demographics
NPI:1346528981
Name:MARZY PODIATRY ASSOCIATES PC
Entity Type:Organization
Organization Name:MARZY PODIATRY ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AREZU
Authorized Official - Middle Name:
Authorized Official - Last Name:IZAD
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:516-660-2171
Mailing Address - Street 1:PO BOX 8
Mailing Address - Street 2:
Mailing Address - City:ROSLYN HTS
Mailing Address - State:NY
Mailing Address - Zip Code:11577-0008
Mailing Address - Country:US
Mailing Address - Phone:516-660-2171
Mailing Address - Fax:516-625-3260
Practice Address - Street 1:26701 HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:FLORAL PARK
Practice Address - State:NY
Practice Address - Zip Code:11004-1743
Practice Address - Country:US
Practice Address - Phone:718-343-7790
Practice Address - Fax:718-206-1289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-01
Last Update Date:2011-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN004578213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01154076Medicaid