Provider Demographics
NPI:1831178284
Name:ABOUEZZI, ZIAD ELIE (MD)
Entity type:Individual
Prefix:MR
First Name:ZIAD
Middle Name:ELIE
Last Name:ABOUEZZI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1 WEBSTER AVE STE 502
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-1363
Mailing Address - Country:US
Mailing Address - Phone:845-452-5741
Mailing Address - Fax:845-452-4530
Practice Address - Street 1:ONE FIELD CT
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601
Practice Address - Country:US
Practice Address - Phone:845-452-5258
Practice Address - Fax:845-452-4530
Is Sole Proprietor?:No
Enumeration Date:2006-01-13
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY210196208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
020047566OtherRAILROAD MEDICARE UNITED1
NY1004475OtherCDPHP
318484OtherMVP SELECTCARE INC
NY01831694Medicaid
NY2322067OtherAETNA
G76621Medicare UPIN
NY75L642Medicare ID - Type Unspecified