Provider Demographics
NPI:1699978544
Name:MICHAEL P ZUMPANO PHD DC PLLC
Entity type:Organization
Organization Name:MICHAEL P ZUMPANO PHD DC PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:ZUMPANO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, DC
Authorized Official - Phone:585-924-3330
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:SUITE 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:585-924-5349
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX011332111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty