Provider Demographics
NPI:1922163435
Name:ZAMMIELLO, ANTHONY JOHN (DC)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:JOHN
Last Name:ZAMMIELLO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 MIDDLEBUSH RD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:WAPPINGERS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12590-4098
Mailing Address - Country:US
Mailing Address - Phone:845-298-2104
Mailing Address - Fax:845-632-1035
Practice Address - Street 1:66 MIDDLEBUSH RD
Practice Address - Street 2:SUITE 208
Practice Address - City:WAPPINGERS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12590-4098
Practice Address - Country:US
Practice Address - Phone:845-298-2104
Practice Address - Fax:845-632-1035
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-26
Last Update Date:2012-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX009902-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY4XL431Medicare ID - Type UnspecifiedMEDICARE #