Provider Demographics
NPI:1518170505
Name:ZYAMA GOLDMAN MD INC
Entity Type:Organization
Organization Name:ZYAMA GOLDMAN MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ZYAMA
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:216-591-0343
Mailing Address - Street 1:32299 PINETREE RD
Mailing Address - Street 2:
Mailing Address - City:PEPPER PIKE
Mailing Address - State:OH
Mailing Address - Zip Code:44124-5913
Mailing Address - Country:US
Mailing Address - Phone:216-591-0343
Mailing Address - Fax:216-591-9089
Practice Address - Street 1:32299 PINETREE RD
Practice Address - Street 2:
Practice Address - City:PEPPER PIKE
Practice Address - State:OH
Practice Address - Zip Code:44124-5913
Practice Address - Country:US
Practice Address - Phone:216-591-0343
Practice Address - Fax:216-591-9089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35062562G2084P0015X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0015XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychosomatic MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2415596Medicaid
OH9305182Medicare ID - Type Unspecified