Healthcare Provider Details
I. General information
NPI: 1528225091
Provider Name (Legal Business Name): ASHA ZACHARIA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/21/2008
Last Update Date: 05/25/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
500 UNIVERSITY DR
HERSHEY PA
17033
US
IV. Provider business mailing address
2363 PULLMAN WAY
HUMMELSTOWN PA
17036-6829
US
V. Phone/Fax
- Phone: 717-531-8521
- Fax:
- Phone: 717-829-3127
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2080N0001X |
| Taxonomy | Neonatal-Perinatal Medicine Physician |
| License Number | MT192102 |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080N0001X |
| Taxonomy | Neonatal-Perinatal Medicine Physician |
| License Number | MD441310 |
| License Number State | PA |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: