Healthcare Provider Details

I. General information

NPI: 1912080516
Provider Name (Legal Business Name): RACHEL HAYA ZYLBERBERG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 03/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7340 EAST BROAD ST
BLACKLICK OH
43004
US

IV. Provider business mailing address

7340 EAST BROAD ST
BLACKLICK OH
43004
US

V. Phone/Fax

Practice location:
  • Phone: 614-322-9720
  • Fax: 614-322-9725
Mailing address:
  • Phone: 614-322-9720
  • Fax: 614-322-9725

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number35-046550-Z
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35-046550-Z
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: