Provider Demographics
NPI:1104217736
Name:SPERO, ZACHARY (DPT)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:
Last Name:SPERO
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 ROBBINS LN
Mailing Address - Street 2:
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-6012
Mailing Address - Country:US
Mailing Address - Phone:516-513-1510
Mailing Address - Fax:516-513-1511
Practice Address - Street 1:300 ROBBINS LN
Practice Address - Street 2:
Practice Address - City:SYOSSET
Practice Address - State:NY
Practice Address - Zip Code:11791-6012
Practice Address - Country:US
Practice Address - Phone:516-513-1510
Practice Address - Fax:516-513-1511
Is Sole Proprietor?:No
Enumeration Date:2015-02-18
Last Update Date:2015-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY038500-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist