Provider Demographics
NPI:1609965912
Name:ZEITLER, EUGENE R (DC)
Entity type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:R
Last Name:ZEITLER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 KENT RD
Mailing Address - Street 2:
Mailing Address - City:NEW MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06776-3485
Mailing Address - Country:US
Mailing Address - Phone:860-355-8000
Mailing Address - Fax:860-350-6291
Practice Address - Street 1:153 S MAIN ST
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:CT
Practice Address - Zip Code:06470-2791
Practice Address - Country:US
Practice Address - Phone:203-426-6600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2013-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001422111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTU89317Medicare UPIN
CT350001356Medicare ID - Type Unspecified