=====================================================
General NPI Number Information
=====================================================
NPI Number | 1225909203
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ZAK JAMES OGDEN DPT
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/15/2025
-----------------------------------------------------
Last Update Date | 09/15/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 417 GEYSER RD
-----------------------------------------------------
City | BALLSTON SPA
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 12020-3022
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 518-587-3256
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 417 GEYSER RD
-----------------------------------------------------
City | BALLSTON SPA
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 12020-3022
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 518-587-3256
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | 054904-01
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------