Healthcare Provider Details

I. General information

NPI: 1023330602
Provider Name (Legal Business Name): FRANK ZIC DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2010
Last Update Date: 01/27/2020
Certification Date: 01/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 GARDINERS AVE
LEVITTOWN NY
11756-3707
US

IV. Provider business mailing address

150 GARDINERS AVE
LEVITTOWN NY
11756-3707
US

V. Phone/Fax

Practice location:
  • Phone: 516-520-5026
  • Fax:
Mailing address:
  • Phone: 516-520-5026
  • Fax: 516-396-0138

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number032228
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: