Provider Demographics
NPI:1447359179
Name:ZAVODNICK, STEVEN (MD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:ZAVODNICK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 BROWNS LN
Mailing Address - Street 2:
Mailing Address - City:VILLANOVA
Mailing Address - State:PA
Mailing Address - Zip Code:19085-1304
Mailing Address - Country:US
Mailing Address - Phone:215-592-7852
Mailing Address - Fax:215-592-7853
Practice Address - Street 1:601 WALNUT ST
Practice Address - Street 2:SUITE 960W
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19106-3332
Practice Address - Country:US
Practice Address - Phone:215-592-7852
Practice Address - Fax:215-592-7853
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD015762E2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAB3976Medicare UPIN
PASZ147152Medicare ID - Type Unspecified