Healthcare Provider Details

I. General information

NPI: 1578170551
Provider Name (Legal Business Name): ANGIE MARIE ZAFFUTO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2020
Last Update Date: 09/24/2020
Certification Date: 09/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 VO TECH DR
OIL CITY PA
16301-3502
US

IV. Provider business mailing address

2441 SHEEP FARM RD
CORSICA PA
15829-4223
US

V. Phone/Fax

Practice location:
  • Phone: 814-676-8686
  • Fax:
Mailing address:
  • Phone: 814-594-0054
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: