Healthcare Provider Details

I. General information

NPI: 1245498195
Provider Name (Legal Business Name): IGOR ZILBERMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2008
Last Update Date: 02/29/2024
Certification Date: 02/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

622 W 168TH ST
NEW YORK NY
10032-3720
US

IV. Provider business mailing address

710 W 168TH ST 7TH FLOOR, ROOM 738
NEW YORK NY
10032-2417
US

V. Phone/Fax

Practice location:
  • Phone: 646-426-6876
  • Fax:
Mailing address:
  • Phone: 646-426-3876
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License Number238821
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License Number238821
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number238821
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number238821-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: