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General NPI Number Information
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NPI Number | 1790753630
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Entity Type | Individual
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Provider Name | TINA CONCETTA ZECCA DO
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Gender | Female
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Dates
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Enumeration Date | 03/08/2006
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Last Update Date | 10/07/2008
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Provider Practice Location Address
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Address Line | 200 WHITE RD STE 205
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City | LITTLE SILVER
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State | NJ
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Zip | 07739-1150
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Country | US
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Telephone | 732-741-8222
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Fax | 732-741-6217
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Provider Business Mailing Address
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Address Line | 200 WHITE RD SUITE 205
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City | LITTLE SILVER
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State | NJ
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Zip | 07739-1150
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Country | US
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Telephone | 732-741-8222
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Fax | 732-741-6217
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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 | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | MB58459
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License Number State | NJ
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