Provider Demographics
NPI:1801847553
Name:MICHAEL A ZULLO,MD,PC
Entity Type:Organization
Organization Name:MICHAEL A ZULLO,MD,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:ZULLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-723-0201
Mailing Address - Street 1:176 JOHNSON RD
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-6308
Mailing Address - Country:US
Mailing Address - Phone:914-723-0201
Mailing Address - Fax:
Practice Address - Street 1:176 JOHNSON RD
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-6308
Practice Address - Country:US
Practice Address - Phone:914-723-0201
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-15
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY131907207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY5708055OtherAETNA INSURANCE ID
NYB14907Medicare UPIN