Provider Demographics
NPI:1801476064
Name:ZACCONE, CHRISTINE (RN)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:ZACCONE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 ROUTE 72
Mailing Address - Street 2:
Mailing Address - City:VINCENTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08088-9608
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:300 BIRMINGHAM RD
Practice Address - Street 2:
Practice Address - City:PEMBERTON
Practice Address - State:NJ
Practice Address - Zip Code:08068-1326
Practice Address - Country:US
Practice Address - Phone:201-575-0667
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-12
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR16294400163WA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)