Provider Demographics
NPI:1992092720
Name:ZEITOUN MEDICAL PLLC
Entity type:Organization
Organization Name:ZEITOUN MEDICAL PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KHALED
Authorized Official - Middle Name:
Authorized Official - Last Name:ZEITOUN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-640-5880
Mailing Address - Street 1:159 W 53RD ST
Mailing Address - Street 2:APT 24C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-6005
Mailing Address - Country:US
Mailing Address - Phone:212-677-5118
Mailing Address - Fax:212-677-5338
Practice Address - Street 1:139 E 23RD ST
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-3794
Practice Address - Country:US
Practice Address - Phone:212-677-5118
Practice Address - Fax:212-677-5338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-30
Last Update Date:2011-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY200343261QA0006X, 261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0006XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Fertility Facility
No261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical