Provider Demographics
NPI:1659728301
Name:AL BIZRI, EHAB (MD)
Entity Type:Individual
Prefix:
First Name:EHAB
Middle Name:
Last Name:AL BIZRI
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 1:100 NICHOLLS ROAD
Mailing Address - Street 2:DEPARTMENT OF ANESTHESIOLOGY - HSC - L4 - ROOM 060
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11794-8480
Mailing Address - Country:US
Mailing Address - Phone:631-444-2078
Mailing Address - Fax:
Practice Address - Street 1:101 NICOLLS RD
Practice Address - Street 2:SUNY AT STONY BROOK, DEPARTMENT OF ANESTHESIOLOGY
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794-8480
Practice Address - Country:US
Practice Address - Phone:631-444-2975
Practice Address - Fax:631-444-2907
Is Sole Proprietor?:No
Enumeration Date:2016-05-23
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT69049207L00000X, 207LP3000X
NY315337207LP3000X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP3000XAllopathic & Osteopathic PhysiciansAnesthesiologyPediatric Anesthesiology