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Individual

JOHN J ZAJAC

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
6505 MARKET ST, BUILDING B, BOARDMAN, OH 44512-3457
(330) 758-1065
(330) 286-5396
Mailing address
4135 BOARDMAN CANFIELD RD, SUITE 101, CANFIELD, OH 44406-9803
(330) 286-5330
(330) 286-5396

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN151392
OH
367500000X
Certified Registered Nurse Anesthetist
RN347015L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000690230
ANTHEM BCBS
OH
05
0824835
OH
01
8210996
MEDICARE PTAN
OH
01
P01360510
MEDICARE RAILROAD
OH
Enumeration date
05/26/2006
Last updated
03/15/2016
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