Provider Demographics
NPI:1801415492
Name:ZELLEY, DAICHI
Entity Type:Individual
Prefix:MR
First Name:DAICHI
Middle Name:
Last Name:ZELLEY
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 1:7648 SUMMERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43235-1842
Mailing Address - Country:US
Mailing Address - Phone:614-800-0085
Mailing Address - Fax:
Practice Address - Street 1:7648 SUMMERWOOD DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43235-1842
Practice Address - Country:US
Practice Address - Phone:614-800-0085
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-13
Last Update Date:2020-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide