MEDICARE: DOUGLAS RAYMOND ZUBIK OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	OT011039	OH

General Provider Information

NPI Number	:	1184217937
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOUGLAS RAYMOND ZUBIK OTR/L

Provider Business Mailing Address
First Line	:	2603 PRINCETON RD
Second Line	:
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44118-4313
Country	:	US
Telephone Number	:	216-392-0217
Fax Number	:

Provider Business Practice Location Address
First Line	:	2603 PRINCETON RD
Second Line	:
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44118-4313
Country	:	US
Telephone Number	:	216-392-0217
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/12/2021
Last Update Date	:	02/12/2021

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Directions to “ DOUGLAS RAYMOND ZUBIK OTR/L” Practice Location

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