Provider Demographics
NPI:1831577865
Name:ZOPPI, MARYANN (LAC)
Entity type:Individual
Prefix:
First Name:MARYANN
Middle Name:
Last Name:ZOPPI
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:26 SCOTCHTOWN AVE
Mailing Address - Street 2:
Mailing Address - City:GOSHEN
Mailing Address - State:NY
Mailing Address - Zip Code:10924-1634
Mailing Address - Country:US
Mailing Address - Phone:845-222-9781
Mailing Address - Fax:
Practice Address - Street 1:633 ROUTE 211 E STE 2
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10941-1781
Practice Address - Country:US
Practice Address - Phone:845-692-3224
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-11
Last Update Date:2015-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002176171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist