Healthcare Provider Details

I. General information

NPI: 1255922373
Provider Name (Legal Business Name): DR. ALBERT HAIM ZIBAK
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2021
Last Update Date: 02/01/2021
Certification Date: 02/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 NEWKIRK AVE
BROOKLYN NY
11226-6595
US

IV. Provider business mailing address

1524 E 14TH ST
BROOKLYN NY
11230-7104
US

V. Phone/Fax

Practice location:
  • Phone: 718-676-5995
  • Fax:
Mailing address:
  • Phone: 646-525-5506
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number067578
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: