Healthcare Provider Details

I. General information

NPI: 1871760900
Provider Name (Legal Business Name): DIMITRY ZILBERMAN D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2008
Last Update Date: 02/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 HOSPITAL AVE
DANBURY CT
06810-6099
US

IV. Provider business mailing address

5311 BLACKISTONE RD
BETHESDA MD
20816-1822
US

V. Phone/Fax

Practice location:
  • Phone: 973-972-5266
  • Fax:
Mailing address:
  • Phone: 732-762-8023
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number46022
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number46022
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number46022
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: