Healthcare Provider Details
I. General information
NPI: 1609025808
Provider Name (Legal Business Name): ROBERT E. ZEITLIN,D.D.S.,P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/11/2008
Last Update Date: 09/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1603 VOORHIES AVE 1ST FLOOR
BROOKLYN NY
11235-3959
US
IV. Provider business mailing address
1603 VOORHIES AVE 1ST FLOOR
BROOKLYN NY
11235-3959
US
V. Phone/Fax
- Phone: 718-332-1778
- Fax: 718-332-5816
- Phone: 718-332-1778
- Fax: 718-332-5816
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QS0112X |
| Taxonomy | Oral and Maxillofacial Surgery Clinic/Center |
| License Number | 031799 |
| License Number State | NY |
VIII. Authorized Official
Name: DR.
ROBERT
E.
ZEITLIN
Title or Position: PRESIDENT/OWNER
Credential: D.D.S.
Phone: 718-332-1778