Provider Demographics
NPI:1639379183
Name:ZALE, DEBORAH L (PA)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:L
Last Name:ZALE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2233 STATE ROUTE 86
Mailing Address - Street 2:
Mailing Address - City:SARANAC LAKE
Mailing Address - State:NY
Mailing Address - Zip Code:12983-5644
Mailing Address - Country:US
Mailing Address - Phone:518-897-2317
Mailing Address - Fax:518-897-2423
Practice Address - Street 1:2233 STATE ROUTE 86
Practice Address - Street 2:
Practice Address - City:SARANAC LAKE
Practice Address - State:NY
Practice Address - Zip Code:12983-5644
Practice Address - Country:US
Practice Address - Phone:518-897-2317
Practice Address - Fax:518-897-2423
Is Sole Proprietor?:No
Enumeration Date:2007-07-23
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY003575-1363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
1245446533OtherADIRONDACK MEDICAL CENTER
NY00363213Medicaid
NY003575-1OtherLICENSE NUMBER
1699709576OtherADIRONDACK MEDICAL CENTER
1699709576OtherADIRONDACK MEDICAL CENTER
1699709576OtherADIRONDACK MEDICAL CENTER
1245446533OtherADIRONDACK MEDICAL CENTER
NY330079Medicare UPIN