Provider Demographics
NPI:1568903417
Name:BARNACLO, ZACHARY (PA-C)
Entity Type:Individual
Prefix:MR
First Name:ZACHARY
Middle Name:
Last Name:BARNACLO
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4129 HUSTON AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45212-2811
Mailing Address - Country:US
Mailing Address - Phone:513-907-7171
Mailing Address - Fax:
Practice Address - Street 1:4129 HUSTON AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45212-2811
Practice Address - Country:US
Practice Address - Phone:513-907-7171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-12
Last Update Date:2017-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant