Healthcare Provider Details

I. General information

NPI: 1528396264
Provider Name (Legal Business Name): JENNIFER MARIE ZAGARINO PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/18/2009
Last Update Date: 06/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1281 E MAIN ST
STAMFORD CT
06902-3544
US

IV. Provider business mailing address

2700 WESTCHESTER AVE FL 2
PURCHASE NY
10577-2547
US

V. Phone/Fax

Practice location:
  • Phone: 203-210-2840
  • Fax: 203-210-2841
Mailing address:
  • Phone: 914-607-5730
  • Fax: 914-457-1195

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number008980
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: