Provider Demographics
NPI:1306594593
Name:DANGORA, ZACHARY MARK (PA-C)
Entity type:Individual
Prefix:MR
First Name:ZACHARY
Middle Name:MARK
Last Name:DANGORA
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:22 RICHFIELD ST
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02171-1312
Mailing Address - Country:US
Mailing Address - Phone:508-505-6928
Mailing Address - Fax:
Practice Address - Street 1:22 RICHFIELD ST
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02171-1312
Practice Address - Country:US
Practice Address - Phone:508-505-6928
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-16
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant