Healthcare Provider Details

I. General information

NPI: 1124816590
Provider Name (Legal Business Name): MADISON ZAPISEK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2025
Last Update Date: 04/28/2025
Certification Date: 04/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1045 JAMES ST
SYRACUSE NY
13203-2730
US

IV. Provider business mailing address

6788 PINE RIDGE RD
AUBURN NY
13021-8788
US

V. Phone/Fax

Practice location:
  • Phone: 315-877-1235
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: