Provider Demographics
NPI:1346287000
Name:ZAGREBELSKY, VLADIMIR (MD)
Entity Type:Individual
Prefix:
First Name:VLADIMIR
Middle Name:
Last Name:ZAGREBELSKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6950 GERMANTOWN AVE
Mailing Address - Street 2:NEW COURTLAND LIFE
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19119-2120
Mailing Address - Country:US
Mailing Address - Phone:215-951-4400
Mailing Address - Fax:215-951-4484
Practice Address - Street 1:6950 GERMANTOWN AVE
Practice Address - Street 2:NEW COURTLAND LIFE
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19119-2120
Practice Address - Country:US
Practice Address - Phone:215-951-4400
Practice Address - Fax:215-951-4484
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2015-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD421961207RG0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA082225Medicare ID - Type Unspecified
PAI13780Medicare UPIN