Provider Demographics
NPI:1497506216
Name:CONNERTON, ZACHARY JOHN
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:JOHN
Last Name:CONNERTON
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:CONVENTUS
Mailing Address - Street 2:1001 MAIN STREET, 5TH FLOOR, OB/GYN
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14203
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:CONVENTUS
Practice Address - Street 2:1001 MAIN STREET, 5TH FLOOR, OB/GYN
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14203
Practice Address - Country:US
Practice Address - Phone:716-323-0615
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-29
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program