Provider Demographics
NPI:1396823779
Name:ZGONIS, ELIN CONSTANTINA (MS PT)
Entity Type:Individual
Prefix:MS
First Name:ELIN
Middle Name:CONSTANTINA
Last Name:ZGONIS
Suffix:
Gender:F
Credentials:MS PT
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:52 LAWRENCE DR APT 513
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01854-3657
Mailing Address - Country:US
Mailing Address - Phone:978-397-0180
Mailing Address - Fax:
Practice Address - Street 1:932 BROADWAY
Practice Address - Street 2:
Practice Address - City:CHELSEA
Practice Address - State:MA
Practice Address - Zip Code:02150-2213
Practice Address - Country:US
Practice Address - Phone:617-889-2250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2010-04-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA15577225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist