Basic Information
| Provider Information | |||||||||
| NPI: | 1669053674 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BRITTINGHAM | ||||||||
| FirstName: | ZACHARY | ||||||||
| MiddleName: | DAVID | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 MARKET ST APT 302 | ||||||||
| Address2: | |||||||||
| City: | CAMDEN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 081022312 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4103828082 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | MSC10 5620 | ||||||||
| Address2: | 1 UNIVERSITY OF NEW MEXICO | ||||||||
| City: | ALBUQUERQUE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 81731 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5052723160 | ||||||||
| FaxNumber: | 5052729427 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/20/2021 | ||||||||
| LastUpdateDate: | 04/15/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/01/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | NJ | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 390200000X | 0000 | NM | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.