Provider Demographics
NPI:1710527080
Name:ZARKO, GARY
Entity Type:Individual
Prefix:
First Name:GARY
Middle Name:
Last Name:ZARKO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W6302 BLUFF RD
Mailing Address - Street 2:
Mailing Address - City:WHITEWATER
Mailing Address - State:WI
Mailing Address - Zip Code:53190-3910
Mailing Address - Country:US
Mailing Address - Phone:262-495-2111
Mailing Address - Fax:813-412-5952
Practice Address - Street 1:W6302 BLUFF RD
Practice Address - Street 2:
Practice Address - City:WHITEWATER
Practice Address - State:WI
Practice Address - Zip Code:53190-3910
Practice Address - Country:US
Practice Address - Phone:262-495-2111
Practice Address - Fax:813-412-5952
Is Sole Proprietor?:No
Enumeration Date:2020-01-14
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide