1790792620 NPI number — DR. DENNIS JOHN ZACCHETTI PSYD, LADC, LMFT

Table of content: DR. DENNIS JOHN ZACCHETTI PSYD, LADC, LMFT (NPI 1790792620)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790792620 NPI number — DR. DENNIS JOHN ZACCHETTI PSYD, LADC, LMFT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ZACCHETTI
Provider First Name:
DENNIS
Provider Middle Name:
JOHN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PSYD, LADC, LMFT
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1790792620
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/13/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PSC 9 BOX 2232
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
APO
Provider Business Mailing Address State Name:
AE
Provider Business Mailing Address Postal Code:
09123-0023
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
496-562-1300
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
WILHELM-WASCHBISCH STR 8
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BEILINGEN
Provider Business Practice Location Address State Name:
RHEINLAN PFALZ
Provider Business Practice Location Address Postal Code:
54662
Provider Business Practice Location Address Country Code:
DE
Provider Business Practice Location Address Telephone Number:
496-562-1300
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/02/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X , with the licence number:  000049 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 101YA0400X , with the licence number: 000761 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YM0800X , with the licence number: 001967 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: #UNAVAILABLE . This is a "COSMO" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: MOU #250 . This is a "TRICARE" identifier , issued by the state of ( WI ) . This identifiers is of the category "OTHER".