MEDICARE: ELLA ZARBAILOV

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	363LG0600X	Gerontology Nurse Practitioner	AG1116104	OH

General Provider Information

NPI Number	:	1730625724
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELLA ZARBAILOV

Provider Business Mailing Address
First Line	:	6565 MAPLEWOOD RD
Second Line	:	APT 201
City	:	MAYFIELD HTS
State	:	OH
Zip	:	44124-1939
Country	:	US
Telephone Number	:	440-409-9607
Fax Number	:

Provider Business Practice Location Address
First Line	:	6565 MAPLEWOOD RD
Second Line	:	APT 201
City	:	MAYFIELD HTS
State	:	OH
Zip	:	44124-1939
Country	:	US
Telephone Number	:	440-409-9607
Fax Number	:

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

Provider Enumeration Date	:	01/13/2017
Last Update Date	:	01/13/2017

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Directions to “ ELLA ZARBAILOV ” Practice Location

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