Provider Demographics
NPI:1568479590
Name:LEO ZYGELMAN
Entity Type:Organization
Organization Name:LEO ZYGELMAN
Other - Org Name:ORANGE CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LEO
Authorized Official - Middle Name:
Authorized Official - Last Name:ZYGELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:203-795-5244
Mailing Address - Street 1:370 BOSTON POST RD
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CT
Mailing Address - Zip Code:06477-3534
Mailing Address - Country:US
Mailing Address - Phone:203-795-5244
Mailing Address - Fax:203-795-9510
Practice Address - Street 1:370 BOSTON POST RD
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CT
Practice Address - Zip Code:06477-3534
Practice Address - Country:US
Practice Address - Phone:203-795-5244
Practice Address - Fax:203-795-9510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-02
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT050000207CT01OtherANTHEM BC/BS
CTNHS471OtherOXFORD INS.
CT5734463OtherAETNA
CT1568479590Medicare PIN
CT350000145Medicare ID - Type UnspecifiedFIRST COAST