Provider Demographics
NPI:1477878262
Name:ZUBEK, AMANDA ELISABETH (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:ELISABETH
Last Name:ZUBEK
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:ELISABETH
Other - Last Name:BASS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:333 CEDAR ST
Mailing Address - Street 2:YALE SCHOOL OF MEDICINE- DERMATOLOGY
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06520
Mailing Address - Country:US
Mailing Address - Phone:203-785-4092
Mailing Address - Fax:203-785-7637
Practice Address - Street 1:1625 STRAITS TPKE STE 306
Practice Address - Street 2:YALE DERMATOLOGY-MIDDLEBURY
Practice Address - City:MIDDLEBURY
Practice Address - State:CT
Practice Address - Zip Code:06762-1836
Practice Address - Country:US
Practice Address - Phone:203-577-1050
Practice Address - Fax:203-577-1053
Is Sole Proprietor?:No
Enumeration Date:2010-04-05
Last Update Date:2014-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT53302207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology