MEDICARE: MICHAEL M ZIEGELBAUM MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208800000X	Urology Physician	23062	ND
2	208800000X	Urology Physician	173612	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174520621
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL M ZIEGELBAUM MD

Provider Business Mailing Address
First Line	:	2001 MARCUS AVE
Second Line	:	SUITE N-214
City	:	LAKE SUCCESS
State	:	NY
Zip	:	11042-1011
Country	:	US
Telephone Number	:	516-437-4228
Fax Number	:	516-355-0637

Provider Business Practice Location Address
First Line	:	2001 MARCUS AVE
Second Line	:	SUITE N-214
City	:	LAKE SUCCESS
State	:	NY
Zip	:	11042-1011
Country	:	US
Telephone Number	:	516-437-4228
Fax Number	:	516-355-0637

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2005
Last Update Date	:	10/17/2025

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