Provider Demographics
NPI:1427621754
Name:ZELS IV INFUSION CENTER LLC
Entity type:Organization
Organization Name:ZELS IV INFUSION CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:IZOLDA
Authorized Official - Middle Name:
Authorized Official - Last Name:IZMAYLOVA
Authorized Official - Suffix:
Authorized Official - Credentials:ANP-C
Authorized Official - Phone:718-790-0815
Mailing Address - Street 1:41 EAGLE RD
Mailing Address - Street 2:
Mailing Address - City:MARLBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:07746-1810
Mailing Address - Country:US
Mailing Address - Phone:718-790-0815
Mailing Address - Fax:
Practice Address - Street 1:223 TAYLORS MILLS RD
Practice Address - Street 2:
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726-3229
Practice Address - Country:US
Practice Address - Phone:718-790-0815
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-23
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Single Specialty