Individual provider Active NPI

Anthony J Zongaro, PH.D., DABPS

  • Clinical Neuropsychologist
  • Philadelphia, PA
National Provider Identifier
1083714307
Registry record updated Mar 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
PS 004983-L Issued in PA
Practice address
10125 Verree Rd
Suite #102
Philadelphia, PA 19116-3611
Phone
(215) 332-1914
Fax
(215) 332-1873
NPI assigned
Sep 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PS 004983-L PA
Clinical Neuropsychologist 103G00000X PS 004983-L PA Primary

Addresses

Primary practice location

10125 Verree Rd
Suite #102
Philadelphia, PA 19116-3611

Mailing address

10125 Verree Rd
Suite #102
Philadelphia, PA 19116-3611
Phone (215) 327-1335

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PS 004983-LPAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Wives Self Help Foundation, Inc Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458086400000",
    "number": "1083714307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10125 VERREE RD",
            "address_2": "SUITE #102",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191163611",
            "telephone_number": "215-327-1335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10125 VERREE RD",
            "address_2": "SUITE #102",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191163611",
            "telephone_number": "215-332-1914",
            "fax_number": "215-332-1873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZONGARO",
        "first_name": "ANTHONY",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "PH.D., DABPS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2016-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS 004983-L",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "PA",
            "license": "PS 004983-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.