Basic Information
Provider Information | |||||||||
NPI: | 1194993931 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | ZARRILLI | ||||||||
FirstName: | GINA | ||||||||
MiddleName: | MARIE | ||||||||
NamePrefix: | DR. | ||||||||
NameSuffix: |   | ||||||||
Credential: | D.O. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 110 BI COUNTY BLVD | ||||||||
Address2: | SUITE 114 | ||||||||
City: | FARMINGDALE | ||||||||
State: | NY | ||||||||
PostalCode: | 117353943 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 6318287417 | ||||||||
FaxNumber: | 6318287494 | ||||||||
Practice Location | |||||||||
Address1: | 110 BI COUNTY BLVD | ||||||||
Address2: | SUITE 114 | ||||||||
City: | FARMINGDALE | ||||||||
State: | NY | ||||||||
PostalCode: | 117353943 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 6318287417 | ||||||||
FaxNumber: | 6318287494 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 02/14/2008 | ||||||||
LastUpdateDate: | 03/26/2014 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RP1001X | 235546-1 | NY | Y |   | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease | 207RH0002X | 235546-1 | NY | N |   | Allopathic & Osteopathic Physicians | Internal Medicine | Hospice and Palliative Medicine |
No ID Information.