Provider Demographics
NPI:1154384782
Name:ZASYPKIN, ALEKSANDR (MD)
Entity type:Individual
Prefix:
First Name:ALEKSANDR
Middle Name:
Last Name:ZASYPKIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2806 E 23RD ST
Mailing Address - Street 2:APT 6B
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-2790
Mailing Address - Country:US
Mailing Address - Phone:718-998-6161
Mailing Address - Fax:718-998-5250
Practice Address - Street 1:2511 OCEAN AVE
Practice Address - Street 2:SUITE #103
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-3950
Practice Address - Country:US
Practice Address - Phone:718-998-6161
Practice Address - Fax:718-998-5250
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY214413207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01953819Medicaid
NYG93456Medicare UPIN
NY01953819Medicaid