Provider Demographics
NPI:1750760062
Name:TZAU, CLARA (DDS)
Entity type:Individual
Prefix:
First Name:CLARA
Middle Name:
Last Name:TZAU
Suffix:
Gender:
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 PARK AVE APT PHA
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-2507
Mailing Address - Country:US
Mailing Address - Phone:646-255-9014
Mailing Address - Fax:
Practice Address - Street 1:64 LIVINGSTON ST
Practice Address - Street 2:APT 6
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-4843
Practice Address - Country:US
Practice Address - Phone:646-255-9014
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-20
Last Update Date:2025-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0570011223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry