Provider Demographics
NPI:1164714689
Name:ICHTER, ZACHARY A (DO)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:A
Last Name:ICHTER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2104 HARRISBURG PIKE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-2644
Mailing Address - Country:US
Mailing Address - Phone:717-544-3626
Mailing Address - Fax:717-544-3628
Practice Address - Street 1:2104 HARRISBURG PIKE
Practice Address - Street 2:SUITE 200
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-2644
Practice Address - Country:US
Practice Address - Phone:717-544-3626
Practice Address - Fax:717-544-3628
Is Sole Proprietor?:No
Enumeration Date:2011-05-03
Last Update Date:2016-08-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20A13988208600000X
PAOS017209207RB0002X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No207RB0002XAllopathic & Osteopathic PhysiciansInternal MedicineObesity Medicine