Provider Demographics
NPI:1376551135
Name:ZAPPALA, SERGIO (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:SERGIO
Middle Name:
Last Name:ZAPPALA
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 N MAIN ST
Mailing Address - Street 2:CNY PHYSICAL THERAPY
Mailing Address - City:NORTH SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13212-1630
Mailing Address - Country:US
Mailing Address - Phone:315-452-5580
Mailing Address - Fax:315-452-5303
Practice Address - Street 1:401 N MAIN ST
Practice Address - Street 2:CNY PHYSICAL THERAPY
Practice Address - City:NORTH SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13212-1630
Practice Address - Country:US
Practice Address - Phone:315-452-5580
Practice Address - Fax:315-452-5303
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012999 1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AA1217Medicare ID - Type Unspecified