Provider Demographics
NPI:1760930788
Name:ZAZULA, JOANN
Entity Type:Individual
Prefix:
First Name:JOANN
Middle Name:
Last Name:ZAZULA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:162 YALE RD
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:PA
Mailing Address - Zip Code:18337-5098
Mailing Address - Country:US
Mailing Address - Phone:845-820-3084
Mailing Address - Fax:
Practice Address - Street 1:162 YALE RD
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:PA
Practice Address - Zip Code:18337-5098
Practice Address - Country:US
Practice Address - Phone:845-820-3084
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-19
Last Update Date:2016-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program