Healthcare Provider Details

I. General information

NPI: 1033186341
Provider Name (Legal Business Name): ALBERT L ZENS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2006
Last Update Date: 01/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19475 N GRAYHAWK DR #1024
SCOTTSDALE AZ
85255-7414
US

IV. Provider business mailing address

19475 N GRAYHAWK DR #1024
SCOTTSDALE AZ
85255-7414
US

V. Phone/Fax

Practice location:
  • Phone: 315-380-8887
  • Fax:
Mailing address:
  • Phone: 315-380-8887
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number128058
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207U00000X
TaxonomyNuclear Medicine Physician
License Number32394
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code207U00000X
TaxonomyNuclear Medicine Physician
License Number128058
License Number StateNY
# 4
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number32394
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: