Individual provider Active NPI

Theodore Zanker, M.D.

  • Child & Adolescent Psychiatry Physician
  • New Haven, CT
National Provider Identifier
1396754479
Registry record updated Aug 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
13142 Issued in CT
Practice address
315 Whitney Ave
New Haven, CT 06511-3715
Phone
(203) 562-9444
Fax
(203) 562-2360
NPI assigned
Aug 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X 13142 CT Primary

Addresses

Primary practice location

315 Whitney Ave
New Haven, CT 06511-3715

Mailing address

315 Whitney Ave
New Haven, CT 06511-3715
Phone (203) 562-9444

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 Medicine

State licenses

LicenseStateTypeSpecialty
13142CTMDChild & Adolescent Psychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1154822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188432000000",
    "number": "1396754479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 WHITNEY AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065113715",
            "telephone_number": "203-562-9444",
            "fax_number": "203-562-2360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 WHITNEY AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065113715",
            "telephone_number": "203-562-9444",
            "fax_number": "203-562-2360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZANKER",
        "first_name": "THEODORE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-06",
        "last_updated": "2007-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CT",
            "license": "13142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2007; 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.