Provider Demographics
NPI:1578558797
Name:ZARILLO, GEORGE (DC)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:
Last Name:ZARILLO
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 1:131 BOICES LN
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12401-1005
Mailing Address - Country:US
Mailing Address - Phone:845-336-4144
Mailing Address - Fax:845-336-4182
Practice Address - Street 1:131 BOICES LN
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-1005
Practice Address - Country:US
Practice Address - Phone:845-336-4144
Practice Address - Fax:845-336-4182
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX0035181111N00000X
NY0037221133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111N00000XChiropractic ProvidersChiropractor
Not Answered133N00000XDietary & Nutritional Service ProvidersNutritionist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY229431OtherNYS WORKERS COMP
NY229431OtherNYS WORKERS COMP