Provider Demographics
NPI:1689960049
Name:ZWIBEL, HALLIE Y (DO)
Entity Type:Individual
Prefix:DR
First Name:HALLIE
Middle Name:Y
Last Name:ZWIBEL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:HALLIE
Other - Middle Name:
Other - Last Name:ZWIBEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:NYIT AHCC NORTHERN BLVD. #8000
Mailing Address - Street 2:
Mailing Address - City:OLD WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11568
Mailing Address - Country:US
Mailing Address - Phone:516-686-1300
Mailing Address - Fax:516-686-7890
Practice Address - Street 1:NYIT AHCC NORTHERN BLVD. #800
Practice Address - Street 2:
Practice Address - City:OLD WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11569
Practice Address - Country:US
Practice Address - Phone:516-686-1300
Practice Address - Fax:515-686-7890
Is Sole Proprietor?:No
Enumeration Date:2011-06-23
Last Update Date:2015-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY267827207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program