Healthcare Provider Details

I. General information

NPI: 1134116866
Provider Name (Legal Business Name): ROBERT M ZACCAGNINI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/27/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

326 FRYE FARM RD
GREENSBURG PA
15601-6479
US

IV. Provider business mailing address

326 FRYE FARM RD
GREENSBURG PA
15601-6479
US

V. Phone/Fax

Practice location:
  • Phone: 724-205-6185
  • Fax: 724-691-0315
Mailing address:
  • Phone: 724-205-6185
  • Fax: 724-691-0315

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD066906L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License NumberMD066906L
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberMD066906L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: