Healthcare Provider Details

I. General information

NPI: 1538628581
Provider Name (Legal Business Name): MICHAEL ANTHONY ZEITCHEK DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2019
Last Update Date: 05/15/2025
Certification Date: 05/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 SUMMIT AVE STE 105
HACKENSACK NJ
07601-1271
US

IV. Provider business mailing address

144 WENTWORTH AVE
ALBERTSON NY
11507-1740
US

V. Phone/Fax

Practice location:
  • Phone: 551-996-2900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number25MB12528600
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: