Provider Demographics
NPI:1407922198
Name:ZIEGELBAUM, ZELIK (RPT)
Entity Type:Individual
Prefix:MR
First Name:ZELIK
Middle Name:
Last Name:ZIEGELBAUM
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 MANORHAVEN BLVD
Mailing Address - Street 2:
Mailing Address - City:PORT WASHINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11050
Mailing Address - Country:US
Mailing Address - Phone:516-944-8798
Mailing Address - Fax:516-944-9354
Practice Address - Street 1:26 MANORHAVEN BLVD
Practice Address - Street 2:
Practice Address - City:PORT WASHINGTON
Practice Address - State:NY
Practice Address - Zip Code:11050
Practice Address - Country:US
Practice Address - Phone:516-944-8798
Practice Address - Fax:516-944-9354
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-27
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7616225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYANC1617OtherOXFORD
NY34301OtherCIGNA
NY34301OtherCIGNA
Q52671Medicare UPIN