Basic Information
| Provider Information | |||||||||
| NPI: | 1992007413 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ZAMPELLA | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | GEORGE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | IV | ||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 555 MADISON AVE FL 2 | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100223418 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6467542000 | ||||||||
| FaxNumber: | 6467549690 | ||||||||
| Practice Location | |||||||||
| Address1: | 555 MADISON AVE FL 2 | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100223418 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6467542000 | ||||||||
| FaxNumber: | 6467549690 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/04/2010 | ||||||||
| LastUpdateDate: | 04/02/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 04/02/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207N00000X | 289511 | NY | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Dermatology |
No ID Information.