Provider Demographics
NPI:1003822628
Name:LYUBOFF, ZINAIDA (MD)
Entity Type:Individual
Prefix:
First Name:ZINAIDA
Middle Name:
Last Name:LYUBOFF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3411 GUIDER AVE APT 6
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-5235
Mailing Address - Country:US
Mailing Address - Phone:718-333-2121
Mailing Address - Fax:718-333-9585
Practice Address - Street 1:135 OCEAN PKWY
Practice Address - Street 2:SUITE 1U
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-2567
Practice Address - Country:US
Practice Address - Phone:718-614-6167
Practice Address - Fax:718-769-0657
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2007-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2142152084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
H07997Medicare UPIN
388R21Medicare PIN