Provider Demographics
NPI:1205322989
Name:ZACCHEO, TAYLOR ANN (OT)
Entity type:Individual
Prefix:MRS
First Name:TAYLOR
Middle Name:ANN
Last Name:ZACCHEO
Suffix:
Gender:F
Credentials:OT
Other - Prefix:MISS
Other - First Name:TAYLOR
Other - Middle Name:ANN
Other - Last Name:FAZIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:215 SEIDMAN AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10312-5529
Mailing Address - Country:US
Mailing Address - Phone:718-916-5027
Mailing Address - Fax:
Practice Address - Street 1:4013 AVENUE U
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234
Practice Address - Country:US
Practice Address - Phone:718-692-4100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-06
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022637225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist