Provider Demographics
NPI:1003120635
Name:ZIESER, THOMAS G
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:G
Last Name:ZIESER
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 1:5 ROCKHILL RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-2384
Mailing Address - Country:US
Mailing Address - Phone:856-669-6606
Mailing Address - Fax:856-669-6606
Practice Address - Street 1:5 ROCKHILL RD
Practice Address - Street 2:SUITE 2
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-2384
Practice Address - Country:US
Practice Address - Phone:856-669-6606
Practice Address - Fax:856-669-6606
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-06
Last Update Date:2010-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ5002993332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies