Provider Demographics
NPI:1831461375
Name:PIERRE G ZALZAL MD PC
Entity Type:Organization
Organization Name:PIERRE G ZALZAL MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PIERRE
Authorized Official - Middle Name:G
Authorized Official - Last Name:ZALZAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-630-5622
Mailing Address - Street 1:450 BAY RIDGE PKWY
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-2702
Mailing Address - Country:US
Mailing Address - Phone:718-630-5622
Mailing Address - Fax:718-748-5841
Practice Address - Street 1:450 BAY RIDGE PKWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-2702
Practice Address - Country:US
Practice Address - Phone:718-630-5622
Practice Address - Fax:718-748-5841
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-30
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1706202084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYE87320Medicare UPIN