Provider Demographics
NPI:1841493962
Name:ZUKER, ELI (DDS)
Entity type:Individual
Prefix:DR
First Name:ELI
Middle Name:
Last Name:ZUKER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:959 WESTWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-4245
Mailing Address - Country:US
Mailing Address - Phone:718-983-9887
Mailing Address - Fax:
Practice Address - Street 1:299 GUYON AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10306-4134
Practice Address - Country:US
Practice Address - Phone:718-987-6400
Practice Address - Fax:718-980-7017
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY337121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice