Healthcare Provider Details

I. General information

NPI: 1154960532
Provider Name (Legal Business Name): ZAMITTI, GIDALY, ABRAMS, COHEN & ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2020
Last Update Date: 05/21/2021
Certification Date: 05/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4009 CORNING PL STE E3
CHARLOTTE NC
28216-1310
US

IV. Provider business mailing address

4009 CORNING PL STE E3
CHARLOTTE NC
28216-1310
US

V. Phone/Fax

Practice location:
  • Phone: 704-486-5880
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: BETH ROMANO
Title or Position: DIRECTOR OF HR
Credential:
Phone: 704-246-8971