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General NPI Number Information
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NPI Number | 1174986178
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Entity Type | Individual
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Provider Name | JACK ZANGARA D.C.
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Gender | Male
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Dates
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Enumeration Date | 03/29/2016
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Last Update Date | 03/29/2016
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Provider Practice Location Address
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Address Line | 384 MARK TREE RD
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City | EAST SETAUKET
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State | NY
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Zip | 11733-1002
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Country | US
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Telephone | 631-561-5185
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Fax |
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Provider Business Mailing Address
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Address Line | 24 GRIFFEN CT
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City | MILLER PLACE
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State | NY
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Zip | 11764-1432
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Country | US
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Telephone | 631-561-5185
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | X012802
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License Number State | NY
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