Provider Demographics
NPI:1679884308
Name:ZAFARANI, AMY JO (DO)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:JO
Last Name:ZAFARANI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3913 W PROSPECT AVE
Mailing Address - Street 2:STE LL1
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54914-8797
Mailing Address - Country:US
Mailing Address - Phone:920-729-7105
Mailing Address - Fax:
Practice Address - Street 1:2501 E ENTERPRISE AVE
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54913-7805
Practice Address - Country:US
Practice Address - Phone:920-729-7105
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-28
Last Update Date:2018-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB09577500207V00000X
WI65505-21207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology