MEDICARE: DR. ANGELO ZUPPA PT, DPT

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	2251X0800X	Orthopedic Physical Therapist	027474	NY

General Provider Information

NPI Number	:	1922104652
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANGELO ZUPPA PT, DPT

Provider Business Mailing Address
First Line	:	105 LAKE HILL RD
Second Line	:	SUITE 4
City	:	BURNT HILLS
State	:	NY
Zip	:	12027-9507
Country	:	US
Telephone Number	:	518-952-7780
Fax Number	:	888-370-2441

Provider Business Practice Location Address
First Line	:	105 LAKE HILL RD
Second Line	:	SUITE 4
City	:	BURNT HILLS
State	:	NY
Zip	:	12027-9507
Country	:	US
Telephone Number	:	518-952-7780
Fax Number	:	888-370-2441

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

Provider Enumeration Date	:	09/16/2006
Last Update Date	:	04/12/2013

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