Basic Information
| Provider Information | |||||||||
| NPI: | 1720421233 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ZANGERLE | ||||||||
| FirstName: | THERESA | ||||||||
| MiddleName: | ANN | ||||||||
| NamePrefix: | MISS | ||||||||
| NameSuffix: | |||||||||
| Credential: | R.D | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | ZANGERLE | ||||||||
| OtherFirstName: | THERESA | ||||||||
| OtherMiddleName: | ANN | ||||||||
| OtherNamePrefix: | MRS. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | R.D | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 159 BARNEGAT RD FL 2 | ||||||||
| Address2: | |||||||||
| City: | POUGHKEEPSIE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 126015401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8454529800 | ||||||||
| FaxNumber: | 8454527691 | ||||||||
| Practice Location | |||||||||
| Address1: | 159 BARNEGAT RD FL 2 | ||||||||
| Address2: | |||||||||
| City: | POUGHKEEPSIE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 126015401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8454529800 | ||||||||
| FaxNumber: | 8454527691 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/15/2013 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
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| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 133V00000X | 007724-1 | NY | Y | Dietary & Nutritional Service Providers | Dietitian, Registered |
No ID Information.