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General NPI Number Information
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NPI Number | 1134396377
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Entity Type | Organization
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Legal Business Name | NEUROSCIENCE CLINICAL RESEARCH MEDICAL PC
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Dates
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Enumeration Date | 05/15/2008
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Last Update Date | 05/15/2008
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Provider Practice Location Address
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Address Line | 342 QUENTIN RD
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City | BROOKLYN
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State | NY
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Zip | 11223-1801
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Country | US
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Telephone | 718-207-8678
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Fax | 718-339-4477
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Provider Business Mailing Address
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Address Line | 1481 ARDEN AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10312-5407
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Country | US
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Telephone | 718-966-4405
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Fax | 718-339-7711
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Authorized Official
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Title or Position | CEO
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Name | DR. ZINOVIY T BENZAR
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Credential | M.D.
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Telephone | 718-207-8678
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 221175
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License Number State | NY
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