Healthcare Provider Details

I. General information

NPI: 1750661906
Provider Name (Legal Business Name): MR. TEODORO G ZAPPIA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2011
Last Update Date: 08/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1653 INDIAN RIVER RD
VIRGINIA BEACH VA
23456-3889
US

IV. Provider business mailing address

1653 INDIAN RIVER RD
VIRGINIA BEACH VA
23456-3889
US

V. Phone/Fax

Practice location:
  • Phone: 757-426-7951
  • Fax: 757-721-7113
Mailing address:
  • Phone: 757-426-7951
  • Fax: 757-721-7113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171WH0202X
TaxonomyHome Modifications Contractor
License Number2701 027107A
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: