Provider Demographics
NPI:1396180725
Name:ZABLOCKI VA MEDICAL CENTER
Entity Type:Organization
Organization Name:ZABLOCKI VA MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VOCATIONAL REHABILITATION COUNSELOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ANTHONY HEALY
Authorized Official - Last Name:BONANNO
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC, CVE
Authorized Official - Phone:414-384-2000
Mailing Address - Street 1:5000 W NATIONAL AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53295-0001
Mailing Address - Country:US
Mailing Address - Phone:414-384-2000
Mailing Address - Fax:414-382-5298
Practice Address - Street 1:5000 W NATIONAL AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53295-0001
Practice Address - Country:US
Practice Address - Phone:414-384-2000
Practice Address - Fax:414-382-5298
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-29
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes286500000XHospitalsMilitary Hospital