Provider Demographics
NPI:1205852191
Name:ZOLLO, LOUIS E (PT)
Entity Type:Individual
Prefix:
First Name:LOUIS
Middle Name:E
Last Name:ZOLLO
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 NEWTON RD
Mailing Address - Street 2:STE 101
Mailing Address - City:PLAISTOW
Mailing Address - State:NH
Mailing Address - Zip Code:03865-2424
Mailing Address - Country:US
Mailing Address - Phone:978-388-7272
Mailing Address - Fax:978-388-7373
Practice Address - Street 1:50 BRIDGE ST
Practice Address - Street 2:SUITE 200
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03101-1699
Practice Address - Country:US
Practice Address - Phone:603-665-9222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2015-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2478225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH08Y002071NH02OtherANTHEM INDIV #
494908OtherTUFTS HEALTH PLAN INDIV #
NHUX4263Medicare PIN
NH08Y002071NH02OtherANTHEM INDIV #
NHZORE7501Medicare ID - Type UnspecifiedMEDICARE INDIV #