Healthcare Provider Details

I. General information

NPI: 1164578027
Provider Name (Legal Business Name): SANDRA C ZUGGI R.N., C .C.A.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 W 9TH ST
CHESTER PA
19013-2040
US

IV. Provider business mailing address

3416 MIDVALE AVE
PHILA PA
19129-1406
US

V. Phone/Fax

Practice location:
  • Phone: 610-497-7282
  • Fax:
Mailing address:
  • Phone: 215-849-3811
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: