Healthcare Provider Details

I. General information

NPI: 1770350779
Provider Name (Legal Business Name): ZAHRA CEPEDA PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/08/2023
Last Update Date: 12/30/2024
Certification Date: 12/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

WRIGHT CENTER
SCRANTON PA
18505
US

IV. Provider business mailing address

329 CHERRY ST
SCRANTON PA
18505-1505
US

V. Phone/Fax

Practice location:
  • Phone: 570-348-6100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberMA065156
License Number StatePA

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: