Provider Demographics
NPI:1366136509
Name:ZOLL, BRITTANY IMEL (PA)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:IMEL
Last Name:ZOLL
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:
Other - Last Name:IMEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BRITTANY IMEL
Mailing Address - Street 1:2215 GENESEE ST
Mailing Address - Street 2:ST. ELIZABETH CON- CREDENTIALING RM 105
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13501-5930
Mailing Address - Country:US
Mailing Address - Phone:315-801-8350
Mailing Address - Fax:
Practice Address - Street 1:ST. ELIZABETH EAST UTICA OFFICE
Practice Address - Street 2:1256 CULVER AVE
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13501-4253
Practice Address - Country:US
Practice Address - Phone:315-738-7186
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-08
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant