Provider Demographics
NPI:1518996222
Name:ZARRELLA, DOMINICK VINCENT (MS,PT)
Entity Type:Individual
Prefix:MR
First Name:DOMINICK
Middle Name:VINCENT
Last Name:ZARRELLA
Suffix:
Gender:M
Credentials:MS,PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7244 CORVETTE CT
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27613-4602
Mailing Address - Country:US
Mailing Address - Phone:919-274-6061
Mailing Address - Fax:
Practice Address - Street 1:809 SPRINGMOOR DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-7739
Practice Address - Country:US
Practice Address - Phone:919-848-7125
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8960225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2504205Medicare ID - Type UnspecifiedPHYSICAL THERAPIST