Provider / Organization | NPI | Date Certified |
---|---|---|
ZACHARY WILLIAM FLACCAVENTO | 1851975577 | 2022-04-28 |
Zachary William Flaccavento is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1851975577. Registration indicates Zachary William Flaccavento is a provider of access to adult/geriatric primary care providers services with a specialization in Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant Access to Pediatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) (Physician Assistant, ) (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) (All Other Specialties & Provider Types, ) (Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers)
Entity Type | Individual |
Provider Name | Mr. Zachary William Flaccavento |
Practice Office Address | 3031 NEW BERN AVE STE 306 RALEIGH, NC US |
Practice Office Telephone | 9192313966 |
Practice Office Fax | 9192313912 |
Mailing Address | 3031 NEW BERN AVE STE 306 RALEIGH, NC 276102989 US |
Business Telephone | 9192313966 |
Business Fax | 9192313912 |
Address | City / State | Phone / Fax |
---|---|---|
4350 US 421 S | Lillington, NC 275466760 | 9108931690 |
Direct Messaging Address [] | [email protected] |
Code | Practice | License No State |
---|---|---|
363A00000X PRIMARY | Access to Adult/Geriatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Physician AssistantAccess to Pediatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Physician Assistant Physician Assistant Physician Assistants & Advanced Practice Nursing Providers Physician Assistant All Other Specialties & Provider Types Physician Assistant Physician Assistants & Advanced Practice Nursing Providers | 0010-11539
NC |