Healthcare Provider Details

I. General information

NPI: 1356750160
Provider Name (Legal Business Name): JOHN RICHARD ZOGARIA P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2014
Last Update Date: 09/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1850 E RIDGE RD
ROCHESTER NY
14622-2448
US

IV. Provider business mailing address

1850 E RIDGE RD
ROCHESTER NY
14622-2448
US

V. Phone/Fax

Practice location:
  • Phone: 585-922-7100
  • Fax: 585-922-7109
Mailing address:
  • Phone: 585-922-7100
  • Fax: 585-922-7109

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number008003-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: