Healthcare Provider Details

I. General information

NPI: 1750306676
Provider Name (Legal Business Name): IGOR ZILBERMAN DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 03/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2829 OCEAN PKWY
BROOKLYN NY
11235-7858
US

IV. Provider business mailing address

2829 OCEAN PKWY
BROOKLYN NY
11235-7858
US

V. Phone/Fax

Practice location:
  • Phone: 718-676-4112
  • Fax: 718-676-4134
Mailing address:
  • Phone: 718-676-4112
  • Fax: 718-676-4134

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License NumberX010830-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code364SF0001X
TaxonomyFamily Health Clinical Nurse Specialist
License NumberF341342-1
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF341342-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: