Provider Demographics
NPI:1154944932
Name:ARNOLD, ZACHARY MICHAEL (PA-C)
Entity type:Individual
Prefix:
First Name:ZACHARY
Middle Name:MICHAEL
Last Name:ARNOLD
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2944 GRIFFITHS PL
Mailing Address - Street 2:
Mailing Address - City:SAUQUOIT
Mailing Address - State:NY
Mailing Address - Zip Code:13456-3102
Mailing Address - Country:US
Mailing Address - Phone:330-635-5431
Mailing Address - Fax:
Practice Address - Street 1:201 FRONT ST
Practice Address - Street 2:
Practice Address - City:BEREA
Practice Address - State:OH
Practice Address - Zip Code:44017-1998
Practice Address - Country:US
Practice Address - Phone:440-826-2221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-27
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X
NY026239363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant