Provider Demographics
NPI:1942766209
Name:ZERRAHN, TORI ANTOINETTE (BS, MSED)
Entity Type:Individual
Prefix:MISS
First Name:TORI
Middle Name:ANTOINETTE
Last Name:ZERRAHN
Suffix:
Gender:F
Credentials:BS, MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:159 W 1ST ST
Mailing Address - Street 2:
Mailing Address - City:OSWEGO
Mailing Address - State:NY
Mailing Address - Zip Code:13126-2045
Mailing Address - Country:US
Mailing Address - Phone:315-342-9575
Mailing Address - Fax:
Practice Address - Street 1:20 CASTLE DR
Practice Address - Street 2:
Practice Address - City:PULASKI
Practice Address - State:NY
Practice Address - Zip Code:13142-4817
Practice Address - Country:US
Practice Address - Phone:315-298-5070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-12
Last Update Date:2019-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1048182161174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist