Healthcare Provider Details

I. General information

NPI: 1790281368
Provider Name (Legal Business Name): HALEY ZYLBERBERG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2018
Last Update Date: 08/26/2024
Certification Date: 08/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1283 YORK AVE 9TH FLOOR
NEW YORK NY
10065
US

IV. Provider business mailing address

1283 YORK AVENUE
NEW YORK NY
10065
US

V. Phone/Fax

Practice location:
  • Phone: 646-962-4000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number327757
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: