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General NPI Number Information
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NPI Number | 1487657094
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Entity Type | Individual
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Provider Name | SCOTT JEFFREY ZUCCALA D.O.
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Gender | Male
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Dates
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Enumeration Date | 05/27/2005
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Last Update Date | 01/21/2016
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Provider Practice Location Address
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Address Line | 240 RED TAIL RD SUITE 1&2
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City | ORCHARD PARK
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State | NY
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Zip | 14127-1581
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Country | US
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Telephone | 716-649-6500
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Fax | 716-649-0031
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Provider Business Mailing Address
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Address Line | 240 RED TAIL RD SUITE 1&2
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City | ORCHARD PARK
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State | NY
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Zip | 14127-1581
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Country | US
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Telephone | 716-649-6500
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Fax | 716-649-0031
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 1957851
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License Number State | NY
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