Healthcare Provider Details

I. General information

NPI: 1700392164
Provider Name (Legal Business Name): ANDREA ARLENE ZUMPANO CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/21/2017
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 ATWELL RD
COOPERSTOWN NY
13326-1301
US

IV. Provider business mailing address

2209 GENESEE ST
UTICA NY
13501-5930
US

V. Phone/Fax

Practice location:
  • Phone: 315-507-7856
  • Fax:
Mailing address:
  • Phone: 315-801-3282
  • Fax: 315-801-8391

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number661011
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: