Healthcare Provider Details

I. General information

NPI: 1235228727
Provider Name (Legal Business Name): NIR J BARZILAI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1575 BLONDELL AVE STE 200
BRONX NY
10461-2665
US

IV. Provider business mailing address

233 OLD COLONY RD
HARTSDALE NY
10530-3609
US

V. Phone/Fax

Practice location:
  • Phone: 866-633-8255
  • Fax:
Mailing address:
  • Phone: 718-430-3144
  • Fax: 718-430-8557

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number184368
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: