Provider Demographics
NPI:1811951536
Name:ZARA, VINCENT L (DC,CCSP)
Entity type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:L
Last Name:ZARA
Suffix:
Gender:M
Credentials:DC,CCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:199 JERICHO TPKE
Mailing Address - Street 2:STE. 204
Mailing Address - City:FLORAL PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11001-2100
Mailing Address - Country:US
Mailing Address - Phone:516-352-2773
Mailing Address - Fax:516-352-2774
Practice Address - Street 1:199 JERICHO TPKE
Practice Address - Street 2:STE. 204
Practice Address - City:FLORAL PARK
Practice Address - State:NY
Practice Address - Zip Code:11001-2100
Practice Address - Country:US
Practice Address - Phone:516-352-2773
Practice Address - Fax:516-352-2774
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-12
Last Update Date:2010-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX007106111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician