Healthcare Provider Details

I. General information

NPI: 1225469372
Provider Name (Legal Business Name): KRISTEN MARIE ZACHER PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRISTEN MARIE COFFEY PA

II. Dates (important events)

Enumeration Date: 11/27/2013
Last Update Date: 11/10/2025
Certification Date: 11/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 WOODLAND ST
HARTFORD CT
06105-1208
US

IV. Provider business mailing address

874 STONY HILL RD
WILBRAHAM MA
01095-2247
US

V. Phone/Fax

Practice location:
  • Phone: 860-714-7446
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number003025
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA101348
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number003025
License Number StateCT
# 4
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number003025
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: