Provider Demographics
NPI:1336292879
Name:ZILBERBERG, MARYA D (MD)
Entity Type:Individual
Prefix:DR
First Name:MARYA
Middle Name:D
Last Name:ZILBERBERG
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:PO BOX 36
Mailing Address - Street 2:1 MAIN ST.
Mailing Address - City:GOSHEN
Mailing Address - State:MA
Mailing Address - Zip Code:01032-0036
Mailing Address - Country:US
Mailing Address - Phone:413-268-3414
Mailing Address - Fax:413-268-3416
Practice Address - Street 1:421 N MAIN ST
Practice Address - Street 2:
Practice Address - City:LEEDS
Practice Address - State:MA
Practice Address - Zip Code:01053-9764
Practice Address - Country:US
Practice Address - Phone:413-268-3414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA151894207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAZIA22950Medicare ID - Type UnspecifiedMEDICARE PART B