1649711235 NPI number — ZACHARIA FACAROS, DPM, LLC

Table of content: (NPI 1649711235)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649711235 NPI number — ZACHARIA FACAROS, DPM, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ZACHARIA FACAROS, DPM, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
FACAROS FOOT AND ANKLE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1649711235
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/25/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4955 STEUBENVILLE PIKE STE 180
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15205-9604
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-838-2255
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4955 STEUBENVILLE PIKE STE 180
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15205-9604
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-838-2255
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/15/2017

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
FACAROS
Authorized Official First Name:
ZACHARIA
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
412-915-5803

Provider Taxonomy Codes

  • Taxonomy code: 213ES0103X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QP1100X , with the licence number: 25MD00333300 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)