Provider Demographics
NPI:1295772424
Name:VOORHIES NEPHROLOGY MEDICAL PC
Entity type:Organization
Organization Name:VOORHIES NEPHROLOGY MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ZACHARY
Authorized Official - Middle Name:ZINOVY
Authorized Official - Last Name:BRENER
Authorized Official - Suffix:
Authorized Official - Credentials:MD,
Authorized Official - Phone:718-648-2162
Mailing Address - Street 1:150 EAST 61 STREET
Mailing Address - Street 2:APT 16 B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065
Mailing Address - Country:US
Mailing Address - Phone:718-648-2162
Mailing Address - Fax:
Practice Address - Street 1:1309 AVENUE P
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-1164
Practice Address - Country:US
Practice Address - Phone:718-648-2162
Practice Address - Fax:718-645-1148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-31
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02239605Medicaid
NY02239605Medicaid