Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251S0007X | Physical Therapist - Sports | PT-4773 | MA |
N | 2251S0007X | Physical Therapist - Sports | PT-9267 | CA |
NPI | 1467446864 |
---|---|
Provider Name | Dr. James E. Zachazewski |
First Address | Needham, MA 02492 |
Second Address | Boston, MA 02114-2621 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2005 |
Last Update Date | 08/07/2007 |