Provider Demographics
NPI:1720421233
Name:ZANGERLE, THERESA ANN (RD)
Entity Type:Individual
Prefix:MISS
First Name:THERESA
Middle Name:ANN
Last Name:ZANGERLE
Suffix:
Gender:F
Credentials:RD
Other - Prefix:MRS
Other - First Name:THERESA
Other - Middle Name:ANN
Other - Last Name:ZANGERLE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RD
Mailing Address - Street 1:159 BARNEGAT RD FL 2
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-5401
Mailing Address - Country:US
Mailing Address - Phone:845-452-9800
Mailing Address - Fax:845-452-7691
Practice Address - Street 1:159 BARNEGAT RD FL 2
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-5401
Practice Address - Country:US
Practice Address - Phone:845-452-9800
Practice Address - Fax:845-452-7691
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007724-1133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered