Healthcare Provider Details

I. General information

NPI: 1083400238
Provider Name (Legal Business Name): AVROHOM ZOBERMAN FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/15/2025
Last Update Date: 05/17/2026
Certification Date: 05/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4426 18TH AVE
BROOKLYN NY
11204-1201
US

IV. Provider business mailing address

4426 18TH AVE
BROOKLYN NY
11204-1201
US

V. Phone/Fax

Practice location:
  • Phone: 718-854-0001
  • Fax:
Mailing address:
  • Phone: 718-854-0001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF356214-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: