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Individual

DIEGO M ZUNIGA COSTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PTA

Contact information

Practice address
70 PARSONAGE RD, GREENWICH, CT 06830-3941
(203) 618-4200
Mailing address
22 TOMPKINS ST, WATERBURY, CT 06708-1459
(203) 419-0381
(203) 419-0389

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
001009
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
004190328
MEDICAID
CT
Enumeration date
08/20/2008
Last updated
02/18/2021
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