Provider Demographics
NPI:1417928607
Name:ZACHS, TODD A (MD)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:A
Last Name:ZACHS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 FARMINGTON AVE
Mailing Address - Street 2:SUITE 3RD FLOOR
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06119-1418
Mailing Address - Country:US
Mailing Address - Phone:860-586-2111
Mailing Address - Fax:860-586-2114
Practice Address - Street 1:901 FARMINGTON AVE
Practice Address - Street 2:SUITE 3RD FLOOR
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06119-1418
Practice Address - Country:US
Practice Address - Phone:860-586-2111
Practice Address - Fax:860-586-2114
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2013-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT029961207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001299610Medicaid
040000356Medicare ID - Type Unspecified
CT001299610Medicaid