Provider Demographics
NPI:1659534329
Name:BROZGOLD, ALIZAH ZAHAVAH (PHD)
Entity type:Individual
Prefix:DR
First Name:ALIZAH
Middle Name:ZAHAVAH
Last Name:BROZGOLD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:174 ELDRIDGE ST
Mailing Address - Street 2:1B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10002
Mailing Address - Country:US
Mailing Address - Phone:212-533-5741
Mailing Address - Fax:
Practice Address - Street 1:174 ELDRIDGE ST
Practice Address - Street 2:1B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002-2954
Practice Address - Country:US
Practice Address - Phone:212-533-5741
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-03
Last Update Date:2008-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009839103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist