Individual
ZACHARIA ISAAC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
125 NASHUA ST, BOSTON, MA 02114-1101
(617) 573-2188
Mailing address
10 HOOSIC DR, CANTON, MA 02021-1226
(781) 575-0573
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
214568
MA
208100000X
Physical Medicine & Rehabilitation Physician
214568
MA
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
214568
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0173991
—
MA
01
—
214568
TUFTS
—
01
—
80621
HARVARD PILGRIM
—
01
—
J25317
BLUE CROSS
—
Enumeration date
01/08/2006
Last updated
10/28/2011
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