Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204C00000X | Sports Medicine Doctor | NY 106284-1 | NY |
Y | 207T00000X | Neurosurgeon | NY 106284-1 | NY |
NPI | 1780812818 |
---|---|
Provider Name | Dr. Bernard Joseph Zumpano |
First Address | Utica, NY 13502-1249 |
Second Address | Utica, NY 13502-1249 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2009 |
Last Update Date | 26/06/2009 |