Basic Information
Provider Information
NPI: 1225639263
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ZELIZNEY
FirstName: KRISTA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 14287 N 87TH ST STE 220
Address2:  
City: SCOTTSDALE
State: AZ
PostalCode: 852603698
CountryCode: US
TelephoneNumber: 6023298250
FaxNumber: 4805651898
Practice Location
Address1: 9097 E DESERT COVE AVE STE 110
Address2:  
City: SCOTTSDALE
State: AZ
PostalCode: 852606276
CountryCode: US
TelephoneNumber: 4808604298
FaxNumber: 4808600165
Other Information
ProviderEnumerationDate: 11/05/2020
LastUpdateDate: 03/03/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/03/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X31528AZY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


Home