Provider Demographics
NPI:1467491498
Name:CARROLL, ZEV EPHRAIM (MD)
Entity Type:Individual
Prefix:DR
First Name:ZEV
Middle Name:EPHRAIM
Last Name:CARROLL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1025 CRESTWOOD RD
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-1633
Mailing Address - Country:US
Mailing Address - Phone:516-569-6828
Mailing Address - Fax:516-569-6828
Practice Address - Street 1:1229 BROADWAY
Practice Address - Street 2:SUITE 108
Practice Address - City:HEWLETT
Practice Address - State:NY
Practice Address - Zip Code:11557-2014
Practice Address - Country:US
Practice Address - Phone:516-295-3860
Practice Address - Fax:516-295-3863
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2017-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY170636207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01845041Medicaid
NYF33646Medicare PIN
NY01845041Medicaid
NY00504Medicare UPIN
NYF33646Medicare UPIN