Provider Demographics
NPI:1093713927
Name:ZAPPIA, BRUCE ALBERT (DPM)
Entity Type:Individual
Prefix:
First Name:BRUCE
Middle Name:ALBERT
Last Name:ZAPPIA
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:575 DEER PARK AVE
Mailing Address - Street 2:
Mailing Address - City:BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11702-1926
Mailing Address - Country:US
Mailing Address - Phone:631-893-9227
Mailing Address - Fax:631-893-6521
Practice Address - Street 1:575 DEER PARK AVE
Practice Address - Street 2:
Practice Address - City:BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11702-1926
Practice Address - Country:US
Practice Address - Phone:631-893-9227
Practice Address - Fax:631-893-6521
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-13
Last Update Date:2009-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN005183213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
U55993Medicare UPIN
NYP13012Medicare PIN