Healthcare Provider Details

I. General information

NPI: 1902352404
Provider Name (Legal Business Name): BERNARD ZAYNER JR. DN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2016
Last Update Date: 08/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 CERRILLOS RD STE. 407
SANTA FE NM
87507-2612
US

IV. Provider business mailing address

3600 CERRILLOS RD STE. 407
SANTA FE NM
87507-2612
US

V. Phone/Fax

Practice location:
  • Phone: 773-297-8852
  • Fax:
Mailing address:
  • Phone: 773-297-8852
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number198000647
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code172P00000X
TaxonomyNaprapath
License Number181000360
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code172P00000X
TaxonomyNaprapath
License Number01019
License Number StateNM
# 4
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number181000360
License Number StateIL
# 5
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number01019
License Number StateNM
# 6
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number01019
License Number StateNM
# 7
Primary TaxonomyN
Taxonomy Code172M00000X
TaxonomyMechanotherapist
License Number181000360
License Number StateIL
# 8
Primary TaxonomyN
Taxonomy Code172M00000X
TaxonomyMechanotherapist
License Number01019
License Number StateNM
# 9
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number181000360
License Number StateIL
# 10
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number181000360
License Number StateIL
# 11
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number01019
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: