Healthcare Provider Details

I. General information

NPI: 1487500948
Provider Name (Legal Business Name): ABIGAIL ZACK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/07/2026
Last Update Date: 03/07/2026
Certification Date: 03/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 ALBERT SABIN WAY
CINCINNATI OH
45229-2838
US

IV. Provider business mailing address

252 STETSON ST APT 201
CINCINNATI OH
45219-7301
US

V. Phone/Fax

Practice location:
  • Phone: 513-558-7416
  • Fax:
Mailing address:
  • Phone: 614-432-2482
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: