Provider Demographics
NPI:1285621284
Name:ZULOVICH, LINDA (DO)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:ZULOVICH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 WOODLAND CENTER DR
Mailing Address - Street 2:
Mailing Address - City:GROVE CITY
Mailing Address - State:PA
Mailing Address - Zip Code:16127-4677
Mailing Address - Country:US
Mailing Address - Phone:724-458-0811
Mailing Address - Fax:724-458-0835
Practice Address - Street 1:15 WOODLAND CENTER DR
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:PA
Practice Address - Zip Code:16127-4677
Practice Address - Country:US
Practice Address - Phone:724-458-0811
Practice Address - Fax:724-458-0835
Is Sole Proprietor?:No
Enumeration Date:2005-10-04
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS008623L2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAF90533Medicare UPIN
PA260044772Medicare PIN
049460Medicare ID - Type Unspecified