Individual
ZACHARY JACOBELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
MA063238
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15511342
CAQH
—
Enumeration date
11/09/2021
Last updated
10/29/2025
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