Healthcare Provider Details

I. General information

NPI: 1174531214
Provider Name (Legal Business Name): ALBERT J ZANETTI, D.O., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 10/19/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

591 N 67TH ST
HARRISBURG PA
17111-4502
US

IV. Provider business mailing address

591 N 67TH ST
HARRISBURG PA
17111-4502
US

V. Phone/Fax

Practice location:
  • Phone: 717-564-2439
  • Fax:
Mailing address:
  • Phone: 717-564-2439
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License NumberOS005685L
License Number StatePA

VIII. Authorized Official

Name: DR. ALBERT JOSEPH ZANETTI
Title or Position: PRESIDENT
Credential: D.O.
Phone: 717-564-2439