Healthcare Provider Details

I. General information

NPI: 1215056700
Provider Name (Legal Business Name): ANDREA ZUCCHIATTI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2007
Last Update Date: 01/08/2020
Certification Date: 01/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 BANK STREET
BATAVIA NY
14020-1649
US

IV. Provider business mailing address

16 BANK STREET
BATAVIA NY
14020-1649
US

V. Phone/Fax

Practice location:
  • Phone: 585-344-5470
  • Fax: 585-344-7451
Mailing address:
  • Phone: 585-344-5470
  • Fax: 585-344-7451

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083P0011X
TaxonomyUndersea and Hyperbaric Medicine (Preventive Medicine) Physician
License Number266346
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number266346
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: