Provider Demographics
NPI:1891974416
Name:IBRAHIM M ZAYNEH MD LLC
Entity Type:Organization
Organization Name:IBRAHIM M ZAYNEH MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IBRAHIM
Authorized Official - Middle Name:M
Authorized Official - Last Name:ZAYNEH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:740-355-6634
Mailing Address - Street 1:2127 25TH ST
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:OH
Mailing Address - Zip Code:45662
Mailing Address - Country:US
Mailing Address - Phone:740-355-6634
Mailing Address - Fax:740-355-1273
Practice Address - Street 1:2127 25TH ST
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:OH
Practice Address - Zip Code:45662
Practice Address - Country:US
Practice Address - Phone:740-355-6634
Practice Address - Fax:740-355-1273
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-31
Last Update Date:2007-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2329537Medicaid
G77055Medicare UPIN
OH2329537Medicaid