Provider Demographics
NPI:1619126612
Name:DEKEL, ZVI (LAC)
Entity Type:Individual
Prefix:
First Name:ZVI
Middle Name:
Last Name:DEKEL
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:ZIKI
Other - Middle Name:
Other - Last Name:DEKEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LAC
Mailing Address - Street 1:928 BROADWAY STE 1207
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-8110
Mailing Address - Country:US
Mailing Address - Phone:917-703-2006
Mailing Address - Fax:
Practice Address - Street 1:928 BROADWAY STE 1207
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-8110
Practice Address - Country:US
Practice Address - Phone:917-703-2006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-15
Last Update Date:2018-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003906171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist