Provider Demographics
NPI:1356449243
Name:ZYLICK, ANNE MATHILDE (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:MATHILDE
Last Name:ZYLICK
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:888 WHITE PLAINS RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:TRUMBULL
Mailing Address - State:CT
Mailing Address - Zip Code:06611-4552
Mailing Address - Country:US
Mailing Address - Phone:203-459-4451
Mailing Address - Fax:203-459-0362
Practice Address - Street 1:888 WHITE PLAINS RD
Practice Address - Street 2:SUITE 110
Practice Address - City:TRUMBULL
Practice Address - State:CT
Practice Address - Zip Code:06611-4552
Practice Address - Country:US
Practice Address - Phone:203-459-4451
Practice Address - Fax:203-459-0362
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2014-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT4449363LA2200X, 364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL307405600Medicaid