Provider Demographics
NPI:1013626431
Name:ROSSI, ZACHARY PAUL (DR)
Entity type:Individual
Prefix:
First Name:ZACHARY
Middle Name:PAUL
Last Name:ROSSI
Suffix:
Gender:M
Credentials:DR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 BRIARWOOD CT
Mailing Address - Street 2:
Mailing Address - City:WHITING
Mailing Address - State:NJ
Mailing Address - Zip Code:08759-3510
Mailing Address - Country:US
Mailing Address - Phone:732-552-9843
Mailing Address - Fax:
Practice Address - Street 1:515 BRICK BLVD
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08723-6009
Practice Address - Country:US
Practice Address - Phone:732-655-9812
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-15
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA02134400208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation