Provider Demographics
NPI:1841338613
Name:MISTRY, ZUBIN (PHD)
Entity type:Individual
Prefix:DR
First Name:ZUBIN
Middle Name:
Last Name:MISTRY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3536 GLENDALE AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-3454
Mailing Address - Country:US
Mailing Address - Phone:419-380-0400
Mailing Address - Fax:419-380-9106
Practice Address - Street 1:3536 GLENDALE AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-3454
Practice Address - Country:US
Practice Address - Phone:419-380-0400
Practice Address - Fax:419-380-9106
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2017-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5423103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical