Provider Demographics
NPI:1215242078
Name:G.R. ZACCARIA & ASSOC. INC.
Entity type:Organization
Organization Name:G.R. ZACCARIA & ASSOC. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:ZACCARIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-457-2004
Mailing Address - Street 1:5100 W TAFT RD
Mailing Address - Street 2:SUITE 1T
Mailing Address - City:LIVERPOOL
Mailing Address - State:NY
Mailing Address - Zip Code:13088-3807
Mailing Address - Country:US
Mailing Address - Phone:315-457-2004
Mailing Address - Fax:315-452-2326
Practice Address - Street 1:5100 W TAFT RD
Practice Address - Street 2:SUITE 1T
Practice Address - City:LIVERPOOL
Practice Address - State:NY
Practice Address - Zip Code:13088-3807
Practice Address - Country:US
Practice Address - Phone:315-457-2004
Practice Address - Fax:315-452-2326
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-17
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY15000019140237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty