1275146664 NPI number — ZACHARIAH JACOB CHARLES BOYDSNEE IDC

Table of content: ZACHARIAH JACOB CHARLES BOYDSNEE IDC (NPI 1275146664)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275146664 NPI number — ZACHARIAH JACOB CHARLES BOYDSNEE IDC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BOYDSNEE
Provider First Name:
ZACHARIAH
Provider Middle Name:
JACOB CHARLES
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
IDC
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:
1275146664
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/14/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
UNIT 100177 BOX 1
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FPO
Provider Business Mailing Address State Name:
AP
Provider Business Mailing Address Postal Code:
96661-7700
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
315-243-0754
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
COMMANDING OFFICER
Provider Second Line Business Practice Location Address:
USS BENFOLD (DDG 65)
Provider Business Practice Location Address City Name:
FPO
Provider Business Practice Location Address State Name:
AP
Provider Business Practice Location Address Postal Code:
96661
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-243-0754
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/26/2020

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: 1710I1002X , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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