Individual
MATTHEW DAVID ZEGIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
77 W BARNEY ST, GOUVERNEUR, NY 13642-1040
(315) 287-1000
Mailing address
77 W BARNEY ST, GOUVERNEUR, NY 13642-1040
(315) 287-1000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
340605
NY
363L00000X
Nurse Practitioner
5001565
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2592662B
—
NC
Enumeration date
04/06/2006
Last updated
03/31/2021
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