Provider Demographics
NPI:1790589638
Name:ZAGABE, PETER
Entity type:Individual
Prefix:MR
First Name:PETER
Middle Name:
Last Name:ZAGABE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 FRONT ST STE 401
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01608-1425
Mailing Address - Country:US
Mailing Address - Phone:774-386-5305
Mailing Address - Fax:
Practice Address - Street 1:100 FRONT ST STE 401
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608-1425
Practice Address - Country:US
Practice Address - Phone:774-386-5305
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-01
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst