Provider Demographics
NPI:1851300412
Name:BARZIDEH, SULIAMAN (MD)
Entity Type:Individual
Prefix:
First Name:SULIAMAN
Middle Name:
Last Name:BARZIDEH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 WOODVILLE LN
Mailing Address - Street 2:
Mailing Address - City:ALBERTSON
Mailing Address - State:NY
Mailing Address - Zip Code:11507-1111
Mailing Address - Country:US
Mailing Address - Phone:718-963-8762
Mailing Address - Fax:718-963-8784
Practice Address - Street 1:760 BROADWAY
Practice Address - Street 2:SURGICAL SUITE 9TH FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206-5317
Practice Address - Country:US
Practice Address - Phone:718-963-8762
Practice Address - Fax:718-963-8784
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY133432208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYB78086Medicare UPIN