Provider Demographics
NPI:1740536564
Name:ZUBATOV, IGOR (RN)
Entity type:Individual
Prefix:MR
First Name:IGOR
Middle Name:
Last Name:ZUBATOV
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 NEPTUNE AVE
Mailing Address - Street 2:APT. 5D
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11224-4560
Mailing Address - Country:US
Mailing Address - Phone:718-258-7228
Mailing Address - Fax:
Practice Address - Street 1:435 NEPTUNE AVE
Practice Address - Street 2:APT. 5D
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11224-4560
Practice Address - Country:US
Practice Address - Phone:718-258-7228
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-30
Last Update Date:2012-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY655078-1163W00000X
NJ26NR 16058300163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse