Healthcare Provider Details

I. General information

NPI: 1699296574
Provider Name (Legal Business Name): SANDRA M ZEBROWSKI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2017
Last Update Date: 06/30/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4350 E COTTON CENTER BLVD STE 100 SUITE 100
PHOENIX AZ
85040-8852
US

IV. Provider business mailing address

2402 E ESPLANADE LN UNIT 601
PHOENIX AZ
85016-4898
US

V. Phone/Fax

Practice location:
  • Phone: 602-414-7521
  • Fax:
Mailing address:
  • Phone: 215-870-8057
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number50568
License Number StateAZ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: