Healthcare Provider Details

I. General information

NPI: 1467446864
Provider Name (Legal Business Name): JAMES E. ZACHAZEWSKI PT, DPT, ATC, SCS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 CAMBRIDGE STREET SUIITE 470
BOSTON MA
02114-2621
US

IV. Provider business mailing address

47 FULLER BROOK AVE
NEEDHAM MA
02492
US

V. Phone/Fax

Practice location:
  • Phone: 617-643-1230
  • Fax: 617-643-3436
Mailing address:
  • Phone: 781-433-0630
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License NumberPT-4773
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License NumberPT-9267
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAT-278
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: