Provider Demographics
NPI:1356434187
Name:ZUBENKO, GEORGE S (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:S
Last Name:ZUBENKO
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12300 PERRY HIGHWAY
Mailing Address - Street 2:SUITE 204
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-7612
Mailing Address - Country:US
Mailing Address - Phone:724-719-2303
Mailing Address - Fax:724-719-2303
Practice Address - Street 1:12300 PERRY HIGHWAY
Practice Address - Street 2:SUITE 204
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-7612
Practice Address - Country:US
Practice Address - Phone:724-719-2303
Practice Address - Fax:724-719-2303
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2019-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD030320E2084P0805X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
376772OtherVALUE OPTIONS & VBH-PA
PA000090579OtherHIGHMARK BCBS
PA000953827Medicaid
183466854OtherUNITED BEHAVIORAL HEALTH