Provider Demographics
NPI:1215953039
Name:ZAPPALA, STEPHEN MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:MICHAEL
Last Name:ZAPPALA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 HAVERHILL ST
Mailing Address - Street 2:DOCTORS PARK I
Mailing Address - City:ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01810-1550
Mailing Address - Country:US
Mailing Address - Phone:978-475-4499
Mailing Address - Fax:978-749-9585
Practice Address - Street 1:140 HAVERHILL ST
Practice Address - Street 2:DOCTORS PARK I
Practice Address - City:ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01810-1550
Practice Address - Country:US
Practice Address - Phone:978-475-4499
Practice Address - Fax:978-749-9585
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA60267174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9772863Medicaid
MAA57166Medicare UPIN
MAJ04040Medicare ID - Type Unspecified