Provider Demographics
NPI:1346755113
Name:ZILBERBERG, MILLA
Entity Type:Individual
Prefix:
First Name:MILLA
Middle Name:
Last Name:ZILBERBERG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 GORDON PL
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-1939
Mailing Address - Country:US
Mailing Address - Phone:646-740-8980
Mailing Address - Fax:
Practice Address - Street 1:20 GORDON PL
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-1939
Practice Address - Country:US
Practice Address - Phone:646-740-8980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-03
Last Update Date:2017-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002367-1171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty