Provider Demographics
NPI:1215173018
Name:ZAGATA, ALLISON (PT, PA)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:ZAGATA
Suffix:
Gender:F
Credentials:PT, PA
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:
Other - Last Name:MEISCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, PA
Mailing Address - Street 1:2301 S BROAD ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19148-3542
Mailing Address - Country:US
Mailing Address - Phone:215-952-9434
Mailing Address - Fax:215-952-1247
Practice Address - Street 1:2301 S BROAD ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19148-3542
Practice Address - Country:US
Practice Address - Phone:215-952-1409
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-29
Last Update Date:2020-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA16767225100000X
PAMA055362363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist