Healthcare Provider Details

I. General information

NPI: 1881907426
Provider Name (Legal Business Name): KATHERINE ZOGBY D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2010
Last Update Date: 07/25/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

73 BURGHER AVE
STATEN ISLAND NY
10304-4000
US

IV. Provider business mailing address

73 BURGHER AVE
STATEN ISLAND NY
10304-4000
US

V. Phone/Fax

Practice location:
  • Phone: 718-887-3939
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberX011555-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: