Provider Demographics
NPI:1205947678
Name:ZONECI MEDICAL PLLC
Entity type:Organization
Organization Name:ZONECI MEDICAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:VITALE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:585-424-3410
Mailing Address - Street 1:2561 LAC DE VILLE BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-5645
Mailing Address - Country:US
Mailing Address - Phone:585-424-3410
Mailing Address - Fax:585-214-0042
Practice Address - Street 1:2561 LAC DE VILLE BLVD STE 102
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-5645
Practice Address - Country:US
Practice Address - Phone:585-424-3410
Practice Address - Fax:585-214-0042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QM2500X
NY186511-1261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF33732Medicare UPIN
NYBA0916Medicare PIN