Provider Demographics
NPI:1366061020
Name:ZANNOU, ADANTCHEDE L
Entity type:Individual
Prefix:
First Name:ADANTCHEDE
Middle Name:L
Last Name:ZANNOU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2705 MORRIS AVE APT 4A
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10468-3535
Mailing Address - Country:US
Mailing Address - Phone:646-410-6539
Mailing Address - Fax:
Practice Address - Street 1:2705 MORRIS AVE APT 4A
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10468-3535
Practice Address - Country:US
Practice Address - Phone:646-410-6539
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-13
Last Update Date:2020-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247000000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Health Information