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General NPI Number Information
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NPI Number | 1912247982
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Entity Type | Organization
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Legal Business Name | IZD SURGICAL LLP
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Dates
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Enumeration Date | 02/27/2013
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Last Update Date | 02/27/2013
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Provider Practice Location Address
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Address Line | 122 E 76TH ST SUITE 1B
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City | NEW YORK
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State | NY
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Zip | 10021-2833
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Country | US
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Telephone | 917-576-9835
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Fax | 212-249-4425
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Provider Business Mailing Address
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Address Line | 27 MALYSANA LN
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City | NEW ROCHELLE
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State | NY
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Zip | 10805-2125
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Country | US
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Telephone | 917-576-9835
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Fax | 212-249-4425
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Authorized Official
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Title or Position | PARTNER
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Name | DR. JOSEPH C IRACI
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Credential | MD
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Telephone | 917-576-9835
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 134714
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License Number State | NY
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