Provider Demographics
NPI:1235310871
Name:KEPCZYNSKI, ZACHARIAH
Entity Type:Individual
Prefix:
First Name:ZACHARIAH
Middle Name:
Last Name:KEPCZYNSKI
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 1:10820 PENNY RD
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-1916
Mailing Address - Country:US
Mailing Address - Phone:919-481-3150
Mailing Address - Fax:
Practice Address - Street 1:10820 PENNY RD
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-1916
Practice Address - Country:US
Practice Address - Phone:919-481-3150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-26
Last Update Date:2016-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO96082251X0800X
OR61793225100000X
NC16677225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic