Healthcare Provider Details

I. General information

NPI: 1548183643
Provider Name (Legal Business Name): ZACHARY LOVE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: ZACH LOVE

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

134 EVERGEEN PLACE APARTMENT 300
EAST ORANGE NJ
07018
US

IV. Provider business mailing address

56 PHILLIPS RD APT 92A
SOMERSET NJ
08873-2078
US

V. Phone/Fax

Practice location:
  • Phone: 862-245-1106
  • Fax:
Mailing address:
  • Phone: 917-497-0449
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: