Provider Demographics
NPI:1447604293
Name:MAASS, ZACHARY JAMES (DO)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:JAMES
Last Name:MAASS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 ROYCE CIRCLE
Mailing Address - Street 2:
Mailing Address - City:STORRS
Mailing Address - State:CT
Mailing Address - Zip Code:06268-2270
Mailing Address - Country:US
Mailing Address - Phone:860-487-9264
Mailing Address - Fax:860-487-9222
Practice Address - Street 1:1 ROYCE CIRCLE
Practice Address - Street 2:
Practice Address - City:STORRS
Practice Address - State:CT
Practice Address - Zip Code:06268-2270
Practice Address - Country:US
Practice Address - Phone:860-487-9264
Practice Address - Fax:860-487-9222
Is Sole Proprietor?:No
Enumeration Date:2016-04-18
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT066416207Q00000X, 207QS0010X, 207QS0010X
CT390200000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty