Provider Demographics
NPI:1215336516
Name:PAUL ZANGERLE
Entity type:Organization
Organization Name:PAUL ZANGERLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:ZANGERLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-286-8491
Mailing Address - Street 1:1 PROSPECT ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT MORRIS
Mailing Address - State:NY
Mailing Address - Zip Code:14510-1209
Mailing Address - Country:US
Mailing Address - Phone:585-286-8491
Mailing Address - Fax:
Practice Address - Street 1:1 PROSPECT ST
Practice Address - Street 2:
Practice Address - City:MOUNT MORRIS
Practice Address - State:NY
Practice Address - Zip Code:14510-1209
Practice Address - Country:US
Practice Address - Phone:585-286-8491
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-22
Last Update Date:2014-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY00452369251E00000X
NY343554000514E251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health