Healthcare Provider Details

I. General information

NPI: 1770653610
Provider Name (Legal Business Name): ZEINAB S. ELBAZ M.D. ,FRCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

998 CROOKED HILL ROAD BLG 47 NEUROSCIENCE CENTER
BRENTWOOD NY
11717-1087
US

IV. Provider business mailing address

2088 ELLEN DR
MERRICK NY
11566-5404
US

V. Phone/Fax

Practice location:
  • Phone: 631-761-3470
  • Fax: 631-761-2244
Mailing address:
  • Phone: 516-546-7555
  • Fax: 516-546-2323

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084F0202X
TaxonomyForensic Psychiatry Physician
License Number218909
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number218909
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: