Healthcare Provider Details

I. General information

NPI: 1023674751
Provider Name (Legal Business Name): AARON SIMON ZELIKOVICH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2019
Last Update Date: 09/11/2025
Certification Date: 09/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 E 77TH ST
NEW YORK NY
10075-1851
US

IV. Provider business mailing address

340 W 10TH ST # 6200
INDIANAPOLIS IN
46202-3082
US

V. Phone/Fax

Practice location:
  • Phone: 212-434-6400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0008X
TaxonomyNeuromuscular Medicine (Psychiatry & Neurology) Physician
License Number329968
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: