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Individual

KENNEDY M ZACCHEO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
2100 LOUISIANA BLVD NE STE 410, ALBUQUERQUE, NM 87110-5412
(505) 724-4300
(505) 724-4300
Mailing address
265 CLARENDON ST APT 4, BOSTON, MA 02116-2012
(775) 200-4961

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2022-0056
NM

Other

Enumeration date
04/15/2021
Last updated
10/13/2022
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