Provider Demographics
NPI:1629831011
Name:MINZER MEDICAL PC
Entity Type:Organization
Organization Name:MINZER MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:MINZER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:917-656-1106
Mailing Address - Street 1:48 FROST LN UNIT 1
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:NY
Mailing Address - Zip Code:11559-1806
Mailing Address - Country:US
Mailing Address - Phone:908-347-1744
Mailing Address - Fax:
Practice Address - Street 1:135 LINDEN BLVD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-3302
Practice Address - Country:US
Practice Address - Phone:718-576-7000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-30
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty