Healthcare Provider Details

I. General information

NPI: 1528159993
Provider Name (Legal Business Name): DAVID ISRAEL ZUCKER ED.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 06/18/2025
Certification Date: 06/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7799 JOAN DR
WEST CHESTER OH
45069-3682
US

IV. Provider business mailing address

7799 JOAN DR
WEST CHESTER OH
45069-3682
US

V. Phone/Fax

Practice location:
  • Phone: 513-204-5746
  • Fax: 513-229-3707
Mailing address:
  • Phone: 513-204-5746
  • Fax: 513-229-3707

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number3982
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: