Provider Demographics
NPI:1497753883
Name:ZWEIFACH, ERIC (MD)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:ZWEIFACH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 E 69TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-5158
Mailing Address - Country:US
Mailing Address - Phone:212-535-1508
Mailing Address - Fax:212-517-5676
Practice Address - Street 1:131 E 69TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-5158
Practice Address - Country:US
Practice Address - Phone:212-535-1508
Practice Address - Fax:212-517-5676
Is Sole Proprietor?:No
Enumeration Date:2005-07-11
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY213016207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02022493Medicaid
NYG34904Medicare UPIN
NY02022493Medicaid