Healthcare Provider Details

I. General information

NPI: 1417408535
Provider Name (Legal Business Name): VICTORIA M ZAPPI PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2016
Last Update Date: 10/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

680 CENTRE ST
BROCKTON MA
02302-3308
US

IV. Provider business mailing address

680 CENTRE ST
BROCKTON MA
02302-3308
US

V. Phone/Fax

Practice location:
  • Phone: 508-941-7299
  • Fax: 508-941-6299
Mailing address:
  • Phone: 508-941-7299
  • Fax: 508-941-6299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number5867
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: