MR. DONALD KEVIN ZETTERVALL (NPI# 1619959053) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619959053 |
| Entity Type | Individual |
| Full Name | MR. DONALD KEVIN ZETTERVALL |
| Credential | RPH, CDE, CDM |
| Practice Address |
134 Boston Post Rd Suite 2 The Diabetes Center Old Saybrook CT 06475-1548 |
| Practice Telephone | 8603886677 |
| Practice Fax Number | 8603883256 |
| Mailing Telephone | 8603886677 |
| Mailing Fax Number | 8603883256 |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 174400000X | Specialist | 0901-8462 | CT | Other Service Providers |
| X | 183500000X | Pharmacist | 0330002686 | VT | Pharmacy Service Providers |
| X | 183500000X | Pharmacist | 5567 | CT | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | HEALTHNET | OV6291 | 01 |
| Street Address |
134 BOSTON POST RD SUITE 2 THE DIABETES CENTER |
| City | OLD SAYBROOK |
| State | CT |
| Zip Code | 06475-1548 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912464223 | Kathleen Malcolm | Physical Medicine & Rehabilitation | Apple Rehab Saybrook, 1775 Boston Post Rd, Old Saybrook, CT 06475 | 2019-02-22 |
| 1841661469 | Laura M. Shires, Lcsw, LLC | Social Worker | 24 Ledge Road, Old Saybrook, CT 06475 | 2015-10-08 |
| 1316323397 | Robyn Reilly | Nurse Practitioner | 1687 Rte 1, Old Saybrook, CT 06475 | 2015-08-03 |
| 1679858542 | Brandi Taylor | Counselor | 263 Main St., Suite 301, Old Saybrook, CT 06475 | 2011-10-11 |
| 1346545670 | Lucille Wymer Hartman | Mechanotherapist | 1775 Boston Post Road, Old Saybrook, CT 06475 | 2011-01-18 |
| 1508160631 | Whole Health Wellness, LLC | Clinic/Center | 139 Mill Rock Rd E Unit 1522, Old Saybrook, CT 06475 | 2011-01-04 |
| 1184948481 | Maria S. Foss-rand | Counselor | 251 Main St., Suite 100, Old Seybrook, CT 06475 | 2010-03-16 |
| 1467658161 | Rick Morant Dmd Ms LLC | Dentist | 1358 Boston Post Rd, Suite 2, Old Saybrook, CT 06475 | 2007-06-21 |
| 1174724801 | Richard P Benoit Dmd PC | Dentist | 123 Elm Street, Suite 1300, Old Saybrook, CT 06475 | 2007-05-30 |
| 1194932392 | Omotayo Elizabeth Awujoola | Nurse Practitioner | 20 Research Parkway, Old Saybrook, CT 06475 | 2007-05-17 |
| Find all providers in zip 06475 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861859555 | Rpat, Inc | Specialist | 210 Main St, Old Saybrook, CT 06475-2333 | 2016-01-26 |
| 1528248739 | Shoreline Digestive Health Center | Specialist | 929 Boston Post Rd, Old Saybrook, CT 06475-2143 | 2007-11-06 |
| 1508969387 | Michelle Higginson | Specialist | 455 Boston Post Rd, Suite 10, Old Saybrook, CT 06475-1516 | 2006-09-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386261212 | Diana Louise Botticelli | Specialist | 5 Jackson Pl, Darien, CT 06820-2725 | 2020-06-26 |
| 1205465382 | Center for Vascular Medicine Ct, Pllc | Specialist | 136 Berlin Rd Ste 202, Cromwell, CT 06416-2622 | 2020-04-02 |
| 1679103931 | Gail Joan Dalby | Specialist | 1360 Whitney Ave, Hamden, CT 06517-2400 | 2020-01-24 |
| 1982248902 | Tracy Cook | Specialist | 1533 New Britain Ave Ste 2, Farmington, CT 06032-3378 | 2019-11-02 |
| 1477106482 | Elevate Pt- Stamford Pllc | Specialist | 1234 Summer St Ste 102, Stamford, CT 06905-5558 | 2019-07-18 |
| 1598238321 | Amanda Andrade | Specialist | 40 Whippoorwill Rd, Bethel, CT 06801-2723 | 2019-01-03 |
| 1366921827 | Matt Dutton | Specialist | 1 Highpoint Ct, Woodbury, CT 06798-3228 | 2018-08-07 |
| 1013422591 | Connecticut Orthopaedic Specialists, PC | Specialist | 2499 Main St Ste 6, Stratford, CT 06615-5843 | 2017-12-06 |
| 1114430782 | Elevate Professional Services, LLC | Specialist | 19 Old Kings Hwy S Ste 120, Darien, CT 06820-4532 | 2017-11-06 |
| 1417476052 | Lauri Weil | Specialist | 104 Old Washington Rd, Ridgefield, CT 06877-5918 | 2017-09-14 |
| Find all providers with the same taxonomy | ||||
| City | OLD SAYBROOK |
| Zip Code | 06475 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.