Provider Demographics
NPI:1194921163
Name:ZALTA, NOURIEL (MD)
Entity type:Individual
Prefix:
First Name:NOURIEL
Middle Name:
Last Name:ZALTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:NOURIEL
Other - Middle Name:
Other - Last Name:ZALTA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1850 OCEAN PKWY
Mailing Address - Street 2:APT# A9
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-3060
Mailing Address - Country:US
Mailing Address - Phone:347-342-8640
Mailing Address - Fax:
Practice Address - Street 1:1850 OCEAN PKWY
Practice Address - Street 2:APT# A9
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-3060
Practice Address - Country:US
Practice Address - Phone:347-342-8640
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-26
Last Update Date:2010-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY244539282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital