Provider Demographics
NPI:1720066087
Name:ZOLLI, CHRISTINE L (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:L
Last Name:ZOLLI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2333 MORRIS AVE
Mailing Address - Street 2:STE C-115
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-5714
Mailing Address - Country:US
Mailing Address - Phone:908-964-7900
Mailing Address - Fax:908-964-7911
Practice Address - Street 1:2333 MORRIS AVE
Practice Address - Street 2:STE C115
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-5714
Practice Address - Country:US
Practice Address - Phone:908-964-7900
Practice Address - Fax:908-964-7911
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-06
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA026001207W00000X
NJ25MA02607800207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0175706Medicaid
NJ191945Medicare ID - Type Unspecified
D40978Medicare UPIN