Provider Demographics
NPI:1548401292
Name:ZANINELLI, ROCCO M (MD)
Entity Type:Individual
Prefix:DR
First Name:ROCCO
Middle Name:M
Last Name:ZANINELLI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:11 CENTURY HILL DRIVE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-2151
Mailing Address - Country:US
Mailing Address - Phone:518-713-4595
Mailing Address - Fax:518-713-4598
Practice Address - Street 1:11 CENTURY HILL DRIVE
Practice Address - Street 2:
Practice Address - City:LATHAM
Practice Address - State:NY
Practice Address - Zip Code:12110-2151
Practice Address - Country:US
Practice Address - Phone:518-713-4595
Practice Address - Fax:518-713-4598
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-10
Last Update Date:2012-01-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY183941-12084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYJ400010006Medicare PIN