Provider Demographics
NPI:1780493759
Name:FUENTES, ZACHARY I (PT, DPT)
Entity type:Individual
Prefix:
First Name:ZACHARY
Middle Name:I
Last Name:FUENTES
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:713 POST PL
Mailing Address - Street 2:
Mailing Address - City:SECAUCUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07094-3210
Mailing Address - Country:US
Mailing Address - Phone:201-463-1513
Mailing Address - Fax:
Practice Address - Street 1:713 POST PL
Practice Address - Street 2:
Practice Address - City:SECAUCUS
Practice Address - State:NJ
Practice Address - Zip Code:07094-3210
Practice Address - Country:US
Practice Address - Phone:201-463-1513
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-04
Last Update Date:2025-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic