Provider Demographics
NPI:1598103475
Name:ZYBURA, MORIAH LEIGH (MOT OTR/L)
Entity Type:Individual
Prefix:
First Name:MORIAH
Middle Name:LEIGH
Last Name:ZYBURA
Suffix:
Gender:F
Credentials:MOT OTR/L
Other - Prefix:
Other - First Name:MORIAH
Other - Middle Name:LEIGH
Other - Last Name:UNCAPHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MOT OTR/L
Mailing Address - Street 1:1404 HAY ST
Mailing Address - Street 2:
Mailing Address - City:BERLIN
Mailing Address - State:PA
Mailing Address - Zip Code:15530-1455
Mailing Address - Country:US
Mailing Address - Phone:814-267-4212
Mailing Address - Fax:
Practice Address - Street 1:1404 HAY ST
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:PA
Practice Address - Zip Code:15530-1455
Practice Address - Country:US
Practice Address - Phone:814-267-4212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-12
Last Update Date:2013-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC011478314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility