Provider Demographics
NPI:1730625724
Name:ZARBAILOV, ELLA
Entity type:Individual
Prefix:
First Name:ELLA
Middle Name:
Last Name:ZARBAILOV
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6565 MAPLEWOOD RD
Mailing Address - Street 2:APT 201
Mailing Address - City:MAYFIELD HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44124-1939
Mailing Address - Country:US
Mailing Address - Phone:440-409-9607
Mailing Address - Fax:
Practice Address - Street 1:6565 MAPLEWOOD RD
Practice Address - Street 2:APT 201
Practice Address - City:MAYFIELD HTS
Practice Address - State:OH
Practice Address - Zip Code:44124-1939
Practice Address - Country:US
Practice Address - Phone:440-409-9607
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-13
Last Update Date:2017-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAG1116104363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology