Provider Demographics
NPI:1609261973
Name:ZIADEH, DEBRA (RN)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:
Last Name:ZIADEH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 116
Mailing Address - Street 2:
Mailing Address - City:BUCKEYE LAKE
Mailing Address - State:OH
Mailing Address - Zip Code:43008-0116
Mailing Address - Country:US
Mailing Address - Phone:740-994-4301
Mailing Address - Fax:740-205-0097
Practice Address - Street 1:11097 HEBRON RD.
Practice Address - Street 2:UNIT B
Practice Address - City:BUCKEYE LAKE
Practice Address - State:OH
Practice Address - Zip Code:43008
Practice Address - Country:US
Practice Address - Phone:740-994-4301
Practice Address - Fax:740-205-0097
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-02
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy