Healthcare Provider Details

I. General information

NPI: 1033761218
Provider Name (Legal Business Name): CONSTANCE ZAFFINO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2019
Last Update Date: 07/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4950 W 23RD ST STE 1
ERIE PA
16506-5802
US

IV. Provider business mailing address

4950 W 23RD ST STE 1
ERIE PA
16506-5802
US

V. Phone/Fax

Practice location:
  • Phone: 814-459-2755
  • Fax: 814-456-4873
Mailing address:
  • Phone: 814-459-2755
  • Fax: 814-456-4873

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberSW125681
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: