Provider Demographics
NPI:1407090616
Name:BROOKVILLE HEMATOLOGY ONCOLOGY PLLC
Entity Type:Organization
Organization Name:BROOKVILLE HEMATOLOGY ONCOLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:ZERVOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-609-3010
Mailing Address - Street 1:333 GLEN HEAD RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:GLEN HEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11545-1947
Mailing Address - Country:US
Mailing Address - Phone:516-609-3010
Mailing Address - Fax:516-609-3012
Practice Address - Street 1:333 GLEN HEAD RD
Practice Address - Street 2:SUITE 210
Practice Address - City:GLEN HEAD
Practice Address - State:NY
Practice Address - Zip Code:11545-1947
Practice Address - Country:US
Practice Address - Phone:516-609-3010
Practice Address - Fax:516-609-3012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-01
Last Update Date:2009-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY170701207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty