Provider Demographics
NPI:1588839153
Name:ZUZUKIN, VLADIMIR (MD)
Entity type:Individual
Prefix:DR
First Name:VLADIMIR
Middle Name:
Last Name:ZUZUKIN
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 1:8030 CROWDER BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70127-1072
Mailing Address - Country:US
Mailing Address - Phone:214-934-0200
Mailing Address - Fax:504-324-2336
Practice Address - Street 1:8030 CROWDER BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70127-1072
Practice Address - Country:US
Practice Address - Phone:214-934-0200
Practice Address - Fax:504-324-2336
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-24
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA102001207Y00000X
MDD66458207Y00000X
NY248340207Y00000X
LAMD202364207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1480886Medicaid
LA4P617Medicare PIN