Individual
ZACHARY BEVILACQUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
123 MEDALLION CIR, ROCHESTER, NY 14626-3242
(585) 313-4608
Mailing address
123 MEDALLION CIR, ROCHESTER, NY 14626-3242
Taxonomy
Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
Primary
002336
NY
Other
Enumeration date
10/23/2019
Last updated
10/23/2019
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