Provider Demographics
NPI:1790746501
Name:BARZELAY, LINDA RUTH (MD)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:RUTH
Last Name:BARZELAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 W 66TH ST
Mailing Address - Street 2:11F
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-6214
Mailing Address - Country:US
Mailing Address - Phone:917-656-7608
Mailing Address - Fax:
Practice Address - Street 1:60 W 66TH ST
Practice Address - Street 2:11F
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-6214
Practice Address - Country:US
Practice Address - Phone:917-656-7608
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-31
Last Update Date:2024-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY128097207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00590932Medicaid
NY00590932Medicaid
47A711Medicare ID - Type Unspecified