Provider Demographics
NPI:1649798034
Name:BAYNHAM, ZACHARY JOHN
Entity type:Individual
Prefix:MR
First Name:ZACHARY
Middle Name:JOHN
Last Name:BAYNHAM
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 1:43 PUMPKIN CENTER RD
Mailing Address - Street 2:
Mailing Address - City:FINLEYVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15332-3106
Mailing Address - Country:US
Mailing Address - Phone:412-799-8993
Mailing Address - Fax:
Practice Address - Street 1:43 PUMPKIN CENTER RD
Practice Address - Street 2:
Practice Address - City:FINLEYVILLE
Practice Address - State:PA
Practice Address - Zip Code:15332
Practice Address - Country:US
Practice Address - Phone:412-799-8993
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA2255A2300X, 390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer