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General NPI Number Information
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NPI Number | 1538353826
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Entity Type | Organization
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Legal Business Name | THEODORE ZANKER, M.D., PC
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Dates
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Enumeration Date | 08/30/2007
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Last Update Date | 08/30/2007
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Provider Practice Location Address
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Address Line | 315 WHITNEY AVE
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City | NEW HAVEN
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State | CT
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Zip | 06511-3715
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Country | US
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Telephone | 203-562-9444
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Fax | 203-562-2360
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Provider Business Mailing Address
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Address Line | 315 WHITNEY AVE
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City | NEW HAVEN
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State | CT
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Zip | 06511-3715
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Country | US
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Telephone | 203-562-9444
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Fax | 203-562-2360
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. THEODORE ZANKER
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Credential | M.D.
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Telephone | 203-562-9444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 13142
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License Number State | CT
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