Healthcare Provider Details

I. General information

NPI: 1619767191
Provider Name (Legal Business Name): GABRIEL ZAYAS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2025
Last Update Date: 05/08/2025
Certification Date: 05/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5385 MARKET ST
YOUNGSTOWN OH
44512-2246
US

IV. Provider business mailing address

5385 MARKET ST
YOUNGSTOWN OH
44512-2246
US

V. Phone/Fax

Practice location:
  • Phone: 330-797-4050
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: