MEDICARE: MICHAEL P ZUMPANO PHD DC PLLC

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	111N00000X	Chiropractor	X011332	NY

General Provider Information

NPI Number	:	1699978544
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICHAEL P ZUMPANO PHD DC PLLC

Provider Business Mailing Address
First Line	:	5910 RAYMOND AVE
Second Line	:
City	:	FARMINGTON
State	:	NY
Zip	:	14425-8992
Country	:	US
Telephone Number	:	585-742-2455
Fax Number	:

Provider Business Practice Location Address
First Line	:	6385 STATE ROUTE 96
Second Line	:	SUITE 210 PHOENIX MILLS PLAZA
City	:	VICTOR
State	:	NY
Zip	:	14564-1411
Country	:	US
Telephone Number	:	585-924-3330
Fax Number	:	585-924-5349

Authorized Official
Title or Position	:	SOLE PROPRIETOR
Name	:	DR. MICHAEL PAUL ZUMPANO
Credential	:	PH.D., D.C.
Telephone Number	:	585-924-3330

Provider Enumeration Date	:	06/07/2007
Last Update Date	:	08/22/2020

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