Provider Demographics
NPI:1699585307
Name:ZACKS, DANIEL (PARAMEDIC)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:ZACKS
Suffix:
Gender:M
Credentials:PARAMEDIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 WOOD ST
Mailing Address - Street 2:
Mailing Address - City:LANDER
Mailing Address - State:WY
Mailing Address - Zip Code:82520-2256
Mailing Address - Country:US
Mailing Address - Phone:760-902-5160
Mailing Address - Fax:
Practice Address - Street 1:360 WOOD ST
Practice Address - Street 2:
Practice Address - City:LANDER
Practice Address - State:WY
Practice Address - Zip Code:82520-2256
Practice Address - Country:US
Practice Address - Phone:760-902-5160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-14
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAP05011146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic