Provider Demographics
NPI:1316954639
Name:ZUMPANO, MICHAEL PAUL (PHD, DC)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:PAUL
Last Name:ZUMPANO
Suffix:
Gender:M
Credentials:PHD, DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5910 RAYMOND AVE
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:14425-8992
Mailing Address - Country:US
Mailing Address - Phone:585-742-2455
Mailing Address - Fax:
Practice Address - Street 1:6385 STATE ROUTE 96
Practice Address - Street 2:210 PHOENIX MILLS PLAZA
Practice Address - City:VICTOR
Practice Address - State:NY
Practice Address - Zip Code:14564-1411
Practice Address - Country:US
Practice Address - Phone:585-924-3330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2013-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011332111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor