Provider Demographics
NPI:1720369069
Name:ALZOOBAEE PEDIATRICS, P.C.
Entity Type:Organization
Organization Name:ALZOOBAEE PEDIATRICS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FAIZ
Authorized Official - Middle Name:O
Authorized Official - Last Name:ALZOOBAEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-238-6204
Mailing Address - Street 1:6805 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-6009
Mailing Address - Country:US
Mailing Address - Phone:718-833-7466
Mailing Address - Fax:718-745-7442
Practice Address - Street 1:97 74TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-1904
Practice Address - Country:US
Practice Address - Phone:718-238-6204
Practice Address - Fax:718-238-6205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-31
Last Update Date:2011-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY223071-1208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty