Provider Demographics
NPI:1710924964
Name:ZITSER, GENE (MD)
Entity Type:Individual
Prefix:DR
First Name:GENE
Middle Name:
Last Name:ZITSER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2940 W 5TH ST
Mailing Address - Street 2:APT #11G
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11224-3832
Mailing Address - Country:US
Mailing Address - Phone:917-744-0413
Mailing Address - Fax:718-465-9792
Practice Address - Street 1:21604 UNION TPKE
Practice Address - Street 2:
Practice Address - City:OAKLAND GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11364-3525
Practice Address - Country:US
Practice Address - Phone:718-465-3200
Practice Address - Fax:718-465-9792
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2309722084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02582456Medicaid
NY02582456Medicaid
NYI10914Medicare UPIN