Individual
NICOLAS JAMES ZASTROW
Active
Individual
NICOLAS JAMES ZASTROW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
3658
AZ
363AM0700X
Medical Physician Assistant
3658
AZ
363AS0400X
Surgical Physician Assistant
Primary
3658
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5550830001
MEDICARE NSC SCW
AZ
01
—
5550830003
MEDICARE NSC PEORIA
AZ
01
—
5550830007
MEDICARE NSC DV
AZ
01
—
5550830009
MEDICARE NSC AZ NORTH
AZ
01
—
5550830010
MEDICARE NSC GILBERT
AZ
Enumeration date
08/30/2007
Last updated
01/20/2014
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