Provider Demographics
NPI:1033691373
Name:ALESSI, ZACHARY JW
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:JW
Last Name:ALESSI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142 BURLINGTON AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:DEPEW
Mailing Address - State:NY
Mailing Address - Zip Code:14043-2540
Mailing Address - Country:US
Mailing Address - Phone:716-544-2987
Mailing Address - Fax:
Practice Address - Street 1:1760 WEHRLE DR
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14221-7032
Practice Address - Country:US
Practice Address - Phone:716-544-2987
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-04
Last Update Date:2018-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY064582183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist