Healthcare Provider Details

I. General information

NPI: 1467104075
Provider Name (Legal Business Name): COURTNEY NOELLE ZACCA PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2022
Last Update Date: 01/25/2022
Certification Date: 01/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 LAWN AVE
SELLERSVILLE PA
18960-1548
US

IV. Provider business mailing address

390 E PALETOWN RD
QUAKERTOWN PA
18951-2833
US

V. Phone/Fax

Practice location:
  • Phone: 215-453-4000
  • Fax:
Mailing address:
  • Phone: 475-223-8573
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: