Provider Demographics
NPI:1891812947
Name:ZANGER, EUGENE (PHD)
Entity Type:Individual
Prefix:
First Name:EUGENE
Middle Name:
Last Name:ZANGER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:153 HARBOUR VIEW DRIVE
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758
Mailing Address - Country:US
Mailing Address - Phone:516-541-1423
Mailing Address - Fax:516-541-8557
Practice Address - Street 1:153 HARBOUR VIEW DRIVE
Practice Address - Street 2:
Practice Address - City:MASSAPEQUA
Practice Address - State:NY
Practice Address - Zip Code:11758
Practice Address - Country:US
Practice Address - Phone:516-541-1423
Practice Address - Fax:516-541-8557
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2024-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1726103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00393095Medicaid