Provider Demographics
NPI:1083072474
Name:ZWERLEIN, ROBERT WALTER (RN)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:WALTER
Last Name:ZWERLEIN
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 WARWICK PL
Mailing Address - Street 2:
Mailing Address - City:PORT WASHINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11050-1821
Mailing Address - Country:US
Mailing Address - Phone:516-708-1522
Mailing Address - Fax:
Practice Address - Street 1:30 WARWICK PL
Practice Address - Street 2:
Practice Address - City:PORT WASHINGTON
Practice Address - State:NY
Practice Address - Zip Code:11050-1821
Practice Address - Country:US
Practice Address - Phone:516-708-1522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-01
Last Update Date:2016-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY697484163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse