Provider Demographics
NPI:1821175274
Name:LICHTENSTEIN-ZAYNEH, SONJA (MD)
Entity Type:Individual
Prefix:
First Name:SONJA
Middle Name:
Last Name:LICHTENSTEIN-ZAYNEH
Suffix:
Gender:F
Credentials:MD
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 2379
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41105-2379
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:617 23RD ST STE 215
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101-2870
Practice Address - Country:US
Practice Address - Phone:606-408-1260
Practice Address - Fax:606-408-6327
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35081608L208600000X
KY57260208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2339839Medicaid
H71274Medicare UPIN
OH2339839Medicaid