Healthcare Provider Details

I. General information

NPI: 1255201323
Provider Name (Legal Business Name): JAI-MARIE ZACCO APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/05/2025
Last Update Date: 02/26/2026
Certification Date: 02/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 FROM RD STE 430A
PARAMUS NJ
07652-3551
US

IV. Provider business mailing address

331 NEWMAN SPRINGS RD STE 220
RED BANK NJ
07701-5792
US

V. Phone/Fax

Practice location:
  • Phone: 551-996-5329
  • Fax: 551-996-0115
Mailing address:
  • Phone: 732-807-0877
  • Fax: 201-751-1680

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ15255600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: