Provider Demographics
NPI:1023381084
Name:ZOHAR, SIMON (DPT)
Entity Type:Individual
Prefix:DR
First Name:SIMON
Middle Name:
Last Name:ZOHAR
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 WIDGER RD
Mailing Address - Street 2:NORTH SHORE PHYSICAL THERAPY
Mailing Address - City:MARBLEHEAD
Mailing Address - State:MA
Mailing Address - Zip Code:01945-2146
Mailing Address - Country:US
Mailing Address - Phone:781-631-8250
Mailing Address - Fax:781-639-2060
Practice Address - Street 1:1 WIDGER RD
Practice Address - Street 2:NORTH SHORE PHYSICAL THERAPY
Practice Address - City:MARBLEHEAD
Practice Address - State:MA
Practice Address - Zip Code:01945-2146
Practice Address - Country:US
Practice Address - Phone:781-631-8250
Practice Address - Fax:781-639-2060
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-21
Last Update Date:2012-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA19932225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist