MEDICARE: MRS. DONNA ARLENE ZANGARA MSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	104991	MA

General Provider Information

NPI Number	:	1255325767
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DONNA ARLENE ZANGARA MSW

Provider Business Mailing Address
First Line	:	23 BUTTERFIELD RD
Second Line	:
City	:	LEXINGTON
State	:	MA
Zip	:	02420-2584
Country	:	US
Telephone Number	:	781-861-9330
Fax Number	:	781-862-8310

Provider Business Practice Location Address
First Line	:	19 MUZZEY ST
Second Line	:	#303
City	:	LEXINGTON
State	:	MA
Zip	:	02421-5256
Country	:	US
Telephone Number	:	781-862-8310
Fax Number	:	781-862-8310

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/12/2005
Last Update Date	:	07/09/2007

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