Healthcare Provider Details

I. General information

NPI: 1518170505
Provider Name (Legal Business Name): ZYAMA GOLDMAN MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32299 PINETREE RD
PEPPER PIKE OH
44124-5913
US

IV. Provider business mailing address

32299 PINETREE RD
PEPPER PIKE OH
44124-5913
US

V. Phone/Fax

Practice location:
  • Phone: 216-591-0343
  • Fax: 216-591-9089
Mailing address:
  • Phone: 216-591-0343
  • Fax: 216-591-9089

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0015X
TaxonomyPsychosomatic Medicine Physician
License Number35062562G
License Number StateOH

VIII. Authorized Official

Name: ZYAMA GOLDMAN
Title or Position: OWNER
Credential: MD
Phone: 216-591-0343