Healthcare Provider Details

I. General information

NPI: 1437233152
Provider Name (Legal Business Name): FAIZ O ALZOOBAEE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 08/31/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6805 5TH AVE
BROOKLYN NY
11220-6009
US

IV. Provider business mailing address

6805 5TH AVE
BROOKLYN NY
11220-6009
US

V. Phone/Fax

Practice location:
  • Phone: 718-833-7466
  • Fax: 718-745-7442
Mailing address:
  • Phone: 718-833-7466
  • Fax: 718-745-7442

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number223071
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: