Basic Information
| Provider Information | |||||||||
| NPI: | 1659728301 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | AL BIZRI | ||||||||
| FirstName: | EHAB | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 NICHOLLS ROAD | ||||||||
| Address2: | DEPARTMENT OF ANESTHESIOLOGY - HSC - L4 - ROOM 060 | ||||||||
| City: | STONY BROOK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117948480 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6314442078 | ||||||||
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| Practice Location | |||||||||
| Address1: | 101 NICOLLS RD | ||||||||
| Address2: | SUNY AT STONY BROOK, DEPARTMENT OF ANESTHESIOLOGY | ||||||||
| City: | STONY BROOK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117948480 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6314442975 | ||||||||
| FaxNumber: | 6314442907 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/23/2016 | ||||||||
| LastUpdateDate: | 03/23/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/23/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 69049 | CT | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207LP3000X | 315337 | NY | N | Allopathic & Osteopathic Physicians | Anesthesiology | Pediatric Anesthesiology | 207LP3000X | 69049 | CT | N | Allopathic & Osteopathic Physicians | Anesthesiology | Pediatric Anesthesiology | 207L00000X | 315337 | NY | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.