Provider Demographics
NPI:1609025808
Name:ROBERT E. ZEITLIN,D.D.S.,P.C.
Entity Type:Organization
Organization Name:ROBERT E. ZEITLIN,D.D.S.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:E
Authorized Official - Last Name:ZEITLIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:718-332-1778
Mailing Address - Street 1:1603 VOORHIES AVE
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-3959
Mailing Address - Country:US
Mailing Address - Phone:718-332-1778
Mailing Address - Fax:718-332-5816
Practice Address - Street 1:1603 VOORHIES AVE
Practice Address - Street 2:1ST FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-3959
Practice Address - Country:US
Practice Address - Phone:718-332-1778
Practice Address - Fax:718-332-5816
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-11
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031799261QS0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS0112XAmbulatory Health Care FacilitiesClinic/CenterOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00396323Medicaid
NY0012058OtherGHI
NYA6518OtherHIP MEDICAID
NYA6518OtherHIP MEDICAID
NYT49487Medicare UPIN