| Provider / Organization | NPI | Date Certified |
|---|---|---|
| TZAITI SUDAK | 1629730338 | 2021-10-10 |
Tzaiti Sudak is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1629730338. Registration indicates Tzaiti Sudak is a provider of services with a specialization in Specialist (Other Service Providers, Specialist) (All Other Specialties & Provider Types, ) (Specialist, Other Service Providers) (Specialist, ) (Other Service Providers, Specialist) (All Other Specialties & Provider Types, ) (Specialist, Other Service Providers)
| Entity Type | Individual |
| Provider Name | Tzaiti Sudak |
| Practice Office Address | 1312 38TH ST BROOKLYN, NY US |
| Practice Office Telephone | 7186863700 |
| Mailing Address | 1312 38TH ST BROOKLYN, NY 112183612 US |
| Business Telephone | 7186863700 |
| Code | Practice | License No State |
|---|---|---|
| 174400000X | Specialist Other Service Providers Specialist All Other Specialties & Provider Types Specialist Other Service Providers | |
| 174400000X PRIMARY | Specialist Other Service Providers Specialist All Other Specialties & Provider Types Specialist Other Service Providers |
NY |