Provider Demographics
NPI:1639293103
Name:ZISU, TRAIAN ADRIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:TRAIAN
Middle Name:ADRIAN
Last Name:ZISU
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 1:252 7TH AVE APT 5E
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-7331
Mailing Address - Country:US
Mailing Address - Phone:212-842-8443
Mailing Address - Fax:
Practice Address - Street 1:265 ACKERMAN AVE
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-4200
Practice Address - Country:US
Practice Address - Phone:201-447-5630
Practice Address - Fax:201-447-0903
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2010-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA065521002084P0800X, 2084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7305508Medicaid
NJ7305508Medicaid
NJG49402Medicare UPIN