Provider Demographics
NPI:1114431996
Name:ZASIMOVICH, ANTHONY MICHAEL III (BA, SLP-A)
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:MICHAEL
Last Name:ZASIMOVICH
Suffix:III
Gender:M
Credentials:BA, SLP-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10190 E CACTUS RD
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-5114
Mailing Address - Country:US
Mailing Address - Phone:510-329-1112
Mailing Address - Fax:
Practice Address - Street 1:10190 E CACTUS RD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-5114
Practice Address - Country:US
Practice Address - Phone:510-329-1112
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-01
Last Update Date:2017-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist