MEDICARE: DR. GEORGE S. ZUBENKO M.D., PH.D.

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	2084P0805X	Geriatric Psychiatry Physician	MD030320E	PA
2	2084P0800X	Psychiatry Physician	MD030320E	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	376772	OTHER		VALUE OPTIONS & VBH-PA
2	000090579	OTHER	PA	HIGHMARK BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	183466854	OTHER		UNITED BEHAVIORAL HEALTH

General Provider Information

NPI Number	:	1356434187
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GEORGE S. ZUBENKO M.D., PH.D.

Provider Business Mailing Address
First Line	:	12300 PERRY HIGHWAY
Second Line	:	SUITE 204
City	:	WEXFORD
State	:	PA
Zip	:	15090-7612
Country	:	US
Telephone Number	:	724-719-2303
Fax Number	:	724-719-2303

Provider Business Practice Location Address
First Line	:	12300 PERRY HIGHWAY
Second Line	:	SUITE 204
City	:	WEXFORD
State	:	PA
Zip	:	15090-7612
Country	:	US
Telephone Number	:	724-719-2303
Fax Number	:	724-719-2303

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

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	07/16/2019

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Directions to “ DR. GEORGE S. ZUBENKO M.D., PH.D.” Practice Location

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