Provider Demographics
NPI:1467513200
Name:ZUSIN, OLEG (DDS)
Entity Type:Individual
Prefix:DR
First Name:OLEG
Middle Name:
Last Name:ZUSIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1140 GRANT AVE
Mailing Address - Street 2:
Mailing Address - City:PELHAM
Mailing Address - State:NY
Mailing Address - Zip Code:10803-3440
Mailing Address - Country:US
Mailing Address - Phone:917-968-5238
Mailing Address - Fax:914-533-3443
Practice Address - Street 1:1140 GRANT AVE
Practice Address - Street 2:
Practice Address - City:PELHAM
Practice Address - State:NY
Practice Address - Zip Code:10803-3440
Practice Address - Country:US
Practice Address - Phone:917-968-5238
Practice Address - Fax:914-533-3443
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2015-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0471941223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics