Healthcare Provider Details

I. General information

NPI: 1902129232
Provider Name (Legal Business Name): ZEV ZYLBERBERG RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2010
Last Update Date: 03/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2480 65 STREET
BROOKLYN NY
11204
US

IV. Provider business mailing address

1234 EAST 10 ST
BROOKLYN NY
11230
US

V. Phone/Fax

Practice location:
  • Phone: 718-376-6563
  • Fax: 718-376-6018
Mailing address:
  • Phone: 718-252-0505
  • Fax: 718-376-6018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number031111
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: