Provider Demographics
NPI:1649460429
Name:ZARUCKI, PATRICK DALE (MLT)
Entity type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:DALE
Last Name:ZARUCKI
Suffix:
Gender:M
Credentials:MLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2356 KIPLING DR
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48310-2331
Mailing Address - Country:US
Mailing Address - Phone:781-974-9661
Mailing Address - Fax:
Practice Address - Street 1:2356 KIPLING DR
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48310-2331
Practice Address - Country:US
Practice Address - Phone:781-974-9661
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-27
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RM2200XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyMedical Laboratory