Provider Demographics
NPI:1184040792
Name:ZOLLO, PAUL
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:ZOLLO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:713 UNION ST
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:12534-3001
Mailing Address - Country:US
Mailing Address - Phone:518-828-4619
Mailing Address - Fax:
Practice Address - Street 1:713 UNION ST
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:NY
Practice Address - Zip Code:12534-3001
Practice Address - Country:US
Practice Address - Phone:518-828-4619
Practice Address - Fax:518-828-1196
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-07
Last Update Date:2014-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY373177-1163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health