Healthcare Provider Details

I. General information

NPI: 1063636652
Provider Name (Legal Business Name): MICHAEL ZAGARE PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2007
Last Update Date: 07/07/2025
Certification Date: 07/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1545 WALNUT AVE
MERRICK NY
11566-2218
US

IV. Provider business mailing address

2001 BUTTERFIELD RD STE 1600
DOWNERS GROVE IL
60515-1211
US

V. Phone/Fax

Practice location:
  • Phone: 516-214-8307
  • Fax: 516-750-9086
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number029447-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: