Basic Information
Provider Information
NPI: 1154904936
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FINK
FirstName: ZACHARY
MiddleName:  
NamePrefix: MR.
NameSuffix:  
Credential: DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 23175 COMMERCE PARK
Address2:  
City: BEACHWOOD
State: OH
PostalCode: 441225806
CountryCode: US
TelephoneNumber: 4404493400
FaxNumber: 4404493402
Practice Location
Address1: 23175 COMMERCE PARK
Address2:  
City: BEACHWOOD
State: OH
PostalCode: 441225806
CountryCode: US
TelephoneNumber: 4404493400
FaxNumber: 4404493402
Other Information
ProviderEnumerationDate: 04/30/2021
LastUpdateDate: 04/30/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/30/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208100000XPT018963OHN Allopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation 
225100000XPT018963OHY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


Home