Healthcare Provider Details

I. General information

NPI: 1801800479
Provider Name (Legal Business Name): ANTHONY R. ZAPPACOSTA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 09/14/2020
Certification Date: 09/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

830 OLD LANCASTER RD SUITE 206
BRYN MAWR PA
19010-3118
US

IV. Provider business mailing address

830 OLD LANCASTER RD SUITE206
BRYN MAWR PA
19010-3118
US

V. Phone/Fax

Practice location:
  • Phone: 610-525-8110
  • Fax:
Mailing address:
  • Phone: 610-525-8110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberMD011737E
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMD01173737E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: