Provider Demographics
NPI:1912080516
Name:ZYLBERBERG, RACHEL HAYA (MD)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:HAYA
Last Name:ZYLBERBERG
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 1:7340 EAST BROAD ST
Mailing Address - Street 2:
Mailing Address - City:BLACKLICK
Mailing Address - State:OH
Mailing Address - Zip Code:43004
Mailing Address - Country:US
Mailing Address - Phone:614-322-9720
Mailing Address - Fax:614-322-9725
Practice Address - Street 1:7340 EAST BROAD ST
Practice Address - Street 2:
Practice Address - City:BLACKLICK
Practice Address - State:OH
Practice Address - Zip Code:43004
Practice Address - Country:US
Practice Address - Phone:614-322-9720
Practice Address - Fax:614-322-9725
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-046550-Z2080N0001X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0641541Medicaid