Healthcare Provider Details

I. General information

NPI: 1730158023
Provider Name (Legal Business Name): LISA J ZACHERT PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 ADAMS ST
N CHELMSFORD MA
01863-1746
US

IV. Provider business mailing address

10 ADAMS ST
N CHELMSFORD MA
01863-1746
US

V. Phone/Fax

Practice location:
  • Phone: 978-251-3159
  • Fax: 978-251-0636
Mailing address:
  • Phone: 978-251-3159
  • Fax: 978-251-0636

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number200
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: