Healthcare Provider Details

I. General information

NPI: 1366729253
Provider Name (Legal Business Name): BARBARA JOAN ZAPKE PHYSICAL THERAPIST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/07/2011
Last Update Date: 11/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

264 N ELM ST
MASSAPEQUA NY
11758-2525
US

IV. Provider business mailing address

PO BOX 584
MERRICK NY
11566-0584
US

V. Phone/Fax

Practice location:
  • Phone: 516-317-6431
  • Fax: 516-797-4861
Mailing address:
  • Phone: 516-317-6431
  • Fax: 516-797-4861

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number004177-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: