Healthcare Provider Details

I. General information

NPI: 1427582923
Provider Name (Legal Business Name): THOMAS ALAN ZUMBAUGH DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2017
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 BOSTON POST RD
ORANGE CT
06477-3229
US

IV. Provider business mailing address

2 BARNES INDUSTRIAL RD S
WALLINGFORD CT
06492-2486
US

V. Phone/Fax

Practice location:
  • Phone: 203-795-4784
  • Fax: 203-799-1179
Mailing address:
  • Phone: 203-626-0160
  • Fax: 203-294-6734

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number07001409A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number1201
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: