Provider Demographics
NPI:1215915251
Name:ZINGULA, ELIZABETH M (OD)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:M
Last Name:ZINGULA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 E BUTLER ST
Mailing Address - Street 2:PO BOX 308
Mailing Address - City:MANCHESTER
Mailing Address - State:IA
Mailing Address - Zip Code:52057-0308
Mailing Address - Country:US
Mailing Address - Phone:563-927-3759
Mailing Address - Fax:563-927-5582
Practice Address - Street 1:105 E BUTLER ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:IA
Practice Address - Zip Code:52057-0308
Practice Address - Country:US
Practice Address - Phone:563-927-3759
Practice Address - Fax:563-927-5582
Is Sole Proprietor?:No
Enumeration Date:2006-01-09
Last Update Date:2010-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA02312152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAP00203925OtherRAILROAD MEDICARE
IA0456194Medicaid
IA38604OtherBCBS
IAV04822Medicare UPIN
IAP00203925OtherRAILROAD MEDICARE
IAI19428Medicare PIN