Provider Demographics
NPI:1598853343
Name:BENZAR, ZINOVIY (MD)
Entity Type:Individual
Prefix:
First Name:ZINOVIY
Middle Name:
Last Name:BENZAR
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 1:1481 ARDEN AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10312-5407
Mailing Address - Country:US
Mailing Address - Phone:718-966-4405
Mailing Address - Fax:718-339-4477
Practice Address - Street 1:342 QUENTIN RD
Practice Address - Street 2:FIRST FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-1801
Practice Address - Country:US
Practice Address - Phone:718-339-7711
Practice Address - Fax:718-339-4477
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2211752084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYH47115Medicare UPIN
NY024BT3Medicare ID - Type Unspecified