Provider Demographics
NPI:1861577421
Name:ZACCONE, GREGORY R (PT, DPT, MSPT, SCS)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:R
Last Name:ZACCONE
Suffix:
Gender:M
Credentials:PT, DPT, MSPT, SCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1203 RIVER RD FL 1
Mailing Address - Street 2:
Mailing Address - City:EDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:07020-1456
Mailing Address - Country:US
Mailing Address - Phone:201-937-3600
Mailing Address - Fax:201-731-5192
Practice Address - Street 1:184 CENTRAL AVE
Practice Address - Street 2:1ST FLOOR
Practice Address - City:OLD TAPPAN
Practice Address - State:NJ
Practice Address - Zip Code:07675-7360
Practice Address - Country:US
Practice Address - Phone:201-937-3600
Practice Address - Fax:201-731-5192
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01107700225100000X, 225100000X
225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
3681077OtherOXFORD HEALTH PLANS
7284586OtherAETNA HEALTH PLANS
2411848OtherUNITED HEALTHCARE
800120716OtherHORIZON BC/BS
1268571OtherCIGNA HEALTH PLANS
3681077OtherOXFORD HEALTH PLANS