Provider Demographics
NPI:1396129763
Name:ZARELLA, ANTHONY JOHN (MS/OD)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:JOHN
Last Name:ZARELLA
Suffix:
Gender:M
Credentials:MS/OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1430 ROLKIN CT STE 103
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-3582
Mailing Address - Country:US
Mailing Address - Phone:434-296-2020
Mailing Address - Fax:434-970-2020
Practice Address - Street 1:1430 ROLKIN CT STE 103
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-3582
Practice Address - Country:US
Practice Address - Phone:434-296-2020
Practice Address - Fax:434-970-2020
Is Sole Proprietor?:No
Enumeration Date:2015-07-16
Last Update Date:2018-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008225152W00000X
NJ27OA00657100152W00000X
VA0618002445152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist