Most Relevant Information
Provider Data
| NPI Number: | 1003459975 |
| Provider Name: | ZACHARY BEVILACQUA |
| Entity Type: | Individual |
| Taxonomy Code: | 204C00000X |
| Specialty: | Neuromusculoskeletal Medicine, Sports Medicine |
| License Number: | 002336 |
Most Important Dates
| Enumeration Date: | 10/23/2019 |
| Last Updated: | 10/23/2019 |
Provider Practice Location
123 MEDALLION CIR
ROCHESTER
NY
146263242
Practice Location Phone/Fax
| Phone: | 5853134608 |
| Fax: |
Provider Mailing Location
123 MEDALLION CIR
ROCHESTER
NY
146263242
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |