Provider Demographics
NPI:1245315340
Name:ZACCARIA, MICHELE (OD)
Entity type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:
Last Name:ZACCARIA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:MICHELE
Other - Middle Name:
Other - Last Name:DONAHOE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:58 WOODLAND FARMS RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15238-2020
Mailing Address - Country:US
Mailing Address - Phone:412-963-0342
Mailing Address - Fax:
Practice Address - Street 1:953 FREEPORT RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15238-3123
Practice Address - Country:US
Practice Address - Phone:412-782-6006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOE005591T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA396347Medicare UPIN