MEDICARE: DR. TODD ZACHS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Y00000X	Otolaryngology Physician	029961	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417928607
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TODD ZACHS M.D.

Provider Business Mailing Address
First Line	:	901 FARMINGTON AVE
Second Line	:	SUITE 3RD FLOOR
City	:	WEST HARTFORD
State	:	CT
Zip	:	06119-1418
Country	:	US
Telephone Number	:	860-586-2111
Fax Number	:	860-586-2114

Provider Business Practice Location Address
First Line	:	1000 ASYLUM AVE RM 1004
Second Line	:
City	:	HARTFORD
State	:	CT
Zip	:	06105-1701
Country	:	US
Telephone Number	:	860-712-8652
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/27/2006
Last Update Date	:	06/17/2024

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