Provider Demographics
NPI:1578510848
Name:ZEITLIN, GARY A (MD)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:A
Last Name:ZEITLIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:56 DOYER AVE
Mailing Address - Street 2:SUITE 1-EF
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10605-1639
Mailing Address - Country:US
Mailing Address - Phone:914-948-0500
Mailing Address - Fax:914-948-0560
Practice Address - Street 1:56 DOYER AVE
Practice Address - Street 2:SUITE 1-EF
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10605-1639
Practice Address - Country:US
Practice Address - Phone:914-948-0500
Practice Address - Fax:914-948-0560
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY226606207R00000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02674862Medicaid
NY659AE1OtherEMPIRE BLUE CROSS & BLUE SHIELD
NY302AZ1Medicare PIN
NY659AE1OtherEMPIRE BLUE CROSS & BLUE SHIELD