Provider Demographics
NPI:1053008730
Name:ZSEVC, MATTHEW VINCENT (CRNA)
Entity type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:VINCENT
Last Name:ZSEVC
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:DR
Other - First Name:MATTHEW
Other - Middle Name:VINCENT
Other - Last Name:ZSEVC
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CRNA
Mailing Address - Street 1:575 LEXINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-6102
Mailing Address - Country:US
Mailing Address - Phone:516-303-6737
Mailing Address - Fax:
Practice Address - Street 1:100 PORT WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:ROSLYN
Practice Address - State:NY
Practice Address - Zip Code:11576-1347
Practice Address - Country:US
Practice Address - Phone:516-627-6624
Practice Address - Fax:516-627-3804
Is Sole Proprietor?:No
Enumeration Date:2023-04-21
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY714262367500000X
NY142812367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered