Provider Demographics
NPI:1174095343
Name:RAMICONE, ZACKARY
Entity type:Individual
Prefix:
First Name:ZACKARY
Middle Name:
Last Name:RAMICONE
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 1:729 S 4TH ST # 3
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19147-3185
Mailing Address - Country:US
Mailing Address - Phone:925-768-6617
Mailing Address - Fax:
Practice Address - Street 1:729 S 4TH ST # 3
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19147-3185
Practice Address - Country:US
Practice Address - Phone:925-768-6617
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-27
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD11743235Z00000X
PA7343917235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist