Healthcare Provider Details

I. General information

NPI: 1447359179
Provider Name (Legal Business Name): STEVEN ZAVODNICK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 WALNUT ST SUITE 960W
PHILADELPHIA PA
19106-3332
US

IV. Provider business mailing address

8 BROWNS LN
VILLANOVA PA
19085-1304
US

V. Phone/Fax

Practice location:
  • Phone: 215-592-7852
  • Fax: 215-592-7853
Mailing address:
  • Phone: 215-592-7852
  • Fax: 215-592-7853

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD015762E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: