Healthcare Provider Details

I. General information

NPI: 1306997457
Provider Name (Legal Business Name): NICOLAS CARL ZAFIROGLU MS, PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 12/30/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 OLD FERN HILL RD SUITE 1 BUILDING A
WEST CHESTER PA
19380-4269
US

IV. Provider business mailing address

915 OLD FERN HILL RD SUITE 1 BUILDING A
WEST CHESTER PA
19380-4269
US

V. Phone/Fax

Practice location:
  • Phone: 610-692-6280
  • Fax:
Mailing address:
  • Phone: 610-692-6280
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberMA052933
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: