Healthcare Provider Details

I. General information

NPI: 1699805010
Provider Name (Legal Business Name): ZINAIDA LEBEDEVA MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 08/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8228 MAYFIELD RD SUITE 2B
CHESTERLAND OH
44026-2594
US

IV. Provider business mailing address

8228 MAYFIELD RD SUITE 2B
CHESTERLAND OH
44026-2594
US

V. Phone/Fax

Practice location:
  • Phone: 440-729-2518
  • Fax:
Mailing address:
  • Phone: 440-729-2518
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number35076360
License Number StateOH

VIII. Authorized Official

Name: ZINAIDA LEBEDEVA
Title or Position: OWNER
Credential: MD
Phone: 440-729-2518