Provider Demographics
NPI:1225075278
Name:VIDELEFSKY, ZELDA (MD)
Entity Type:Individual
Prefix:
First Name:ZELDA
Middle Name:
Last Name:VIDELEFSKY
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 1:555 AMORY ST
Mailing Address - Street 2:STE #4
Mailing Address - City:JAMAICA PLAIN
Mailing Address - State:MA
Mailing Address - Zip Code:02130-2652
Mailing Address - Country:US
Mailing Address - Phone:617-524-1120
Mailing Address - Fax:617-524-5523
Practice Address - Street 1:30 WARREN ST
Practice Address - Street 2:FRANCISCANCHILDREN'S HOSP
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135-3602
Practice Address - Country:US
Practice Address - Phone:617-254-3800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1513532084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry