Provider Demographics
NPI:1568497436
Name:ANZALONE, GERALD A (DC)
Entity Type:Individual
Prefix:DR
First Name:GERALD
Middle Name:A
Last Name:ANZALONE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:875 JUNIPER AVE
Mailing Address - Street 2:
Mailing Address - City:ROBINS
Mailing Address - State:IA
Mailing Address - Zip Code:52328-9671
Mailing Address - Country:US
Mailing Address - Phone:319-350-6533
Mailing Address - Fax:
Practice Address - Street 1:875 JUNIPER AVE
Practice Address - Street 2:
Practice Address - City:ROBINS
Practice Address - State:IA
Practice Address - Zip Code:52328-9671
Practice Address - Country:US
Practice Address - Phone:319-350-6533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2016-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX008552-1111N00000X
VT006-0001009111N00000X
NH510-1197111N00000X
IAIA-006984111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1568497436OtherNPI
NY610536600OtherFECA DCMWC FED WC
NY610536500OtherFEDERAL WC DOL FECA
NYCO-8552-4BOtherNYS WORKERS COMPENSATION
NYX-87601Medicare ID - Type UnspecifiedINDIVIDUAL NUMBER
NY350055049Medicare ID - Type UnspecifiedRAIL ROAD MEDICARE
IA1568497436OtherNPI