Provider Demographics
NPI:1528039518
Name:ZIGO, TINA M (ND)
Entity Type:Individual
Prefix:
First Name:TINA
Middle Name:M
Last Name:ZIGO
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:188 MAIN STREET
Mailing Address - Street 2:SUITE E
Mailing Address - City:MONROE
Mailing Address - State:CT
Mailing Address - Zip Code:06468
Mailing Address - Country:US
Mailing Address - Phone:203-268-1336
Mailing Address - Fax:203-268-1327
Practice Address - Street 1:188 MAIN STREET
Practice Address - Street 2:SUITE E
Practice Address - City:MONROE
Practice Address - State:CT
Practice Address - Zip Code:06468
Practice Address - Country:US
Practice Address - Phone:203-268-1336
Practice Address - Fax:203-268-1327
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000270175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath