Provider Demographics
NPI:1891450292
Name:ZYGLIS, ELLIOT (ND)
Entity Type:Individual
Prefix:
First Name:ELLIOT
Middle Name:
Last Name:ZYGLIS
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 BEECHSTONE APT 1
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-6336
Mailing Address - Country:US
Mailing Address - Phone:716-536-3557
Mailing Address - Fax:
Practice Address - Street 1:501 ISLINGTON ST STE 2B
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-4288
Practice Address - Country:US
Practice Address - Phone:603-610-8882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-01
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0048175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath