Provider Demographics
NPI:1598034258
Name:ZBAR, BRETT IVES WALLY (MD)
Entity Type:Individual
Prefix:DR
First Name:BRETT
Middle Name:IVES WALLY
Last Name:ZBAR
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 1:320 E 72ND ST
Mailing Address - Street 2:APT 5A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4769
Mailing Address - Country:US
Mailing Address - Phone:212-804-6301
Mailing Address - Fax:
Practice Address - Street 1:320 E 72ND ST
Practice Address - Street 2:APT 5A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4769
Practice Address - Country:US
Practice Address - Phone:212-804-6301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-23
Last Update Date:2015-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY216539208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice