Provider Demographics
NPI:1568809416
Name:ZIZZAMIA, PAMELA O (DO)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:O
Last Name:ZIZZAMIA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:
Other - Last Name:OHRI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:146 HAZARD AVE STE 107
Mailing Address - Street 2:
Mailing Address - City:ENFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06082-4566
Mailing Address - Country:US
Mailing Address - Phone:860-386-5167
Mailing Address - Fax:860-962-4005
Practice Address - Street 1:146 HAZARD AVE STE 107
Practice Address - Street 2:
Practice Address - City:ENFIELD
Practice Address - State:CT
Practice Address - Zip Code:06082-4566
Practice Address - Country:US
Practice Address - Phone:860-386-5167
Practice Address - Fax:860-962-4005
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-02
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT55910207R00000X, 207RE0101X
MA273961207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine