Provider Demographics
NPI:1790753630
Name:ZECCA, TINA CONCETTA (DO)
Entity Type:Individual
Prefix:DR
First Name:TINA
Middle Name:CONCETTA
Last Name:ZECCA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:200 WHITE RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:LITTLE SILVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07739-1150
Mailing Address - Country:US
Mailing Address - Phone:732-741-8222
Mailing Address - Fax:732-741-6217
Practice Address - Street 1:200 WHITE RD
Practice Address - Street 2:STE 205
Practice Address - City:LITTLE SILVER
Practice Address - State:NJ
Practice Address - Zip Code:07739-1150
Practice Address - Country:US
Practice Address - Phone:732-741-8222
Practice Address - Fax:732-741-6217
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-08
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMB58459207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ40573OtherAMERIGROUP
NJP1112646OtherOXFORD
NJP00361726OtherRR MEDICARE
NJ0128757OtherGHI
NJ5N9742OtherBLUE CROSS
NJ3K4214OtherHEALTHNET
NJES000043503OtherAMERICHOICE
NJ5472073OtherAETNA PPO
NJ8607403OtherCIGNA
NJ0712593000OtherAMERIHEALTH
NJ1163900OtherHORIZON NJ HEALTH
NJ1380878OtherAETNA HMO
NJ7584709Medicaid
NJ8607403OtherCIGNA
NJ010353V06Medicare PIN