Provider Demographics
NPI:1871356915
Name:ZAGELBAUM, ANDREW B (OD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:B
Last Name:ZAGELBAUM
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:10801 N 32ND ST APT 420
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85028-3254
Mailing Address - Country:US
Mailing Address - Phone:516-725-1401
Mailing Address - Fax:
Practice Address - Street 1:3805 E BELL RD STE 1800
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-2135
Practice Address - Country:US
Practice Address - Phone:602-549-2020
Practice Address - Fax:602-325-5536
Is Sole Proprietor?:No
Enumeration Date:2024-02-01
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZOPT-002765152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist