Provider Demographics
NPI:1164933891
Name:ZENTKOVICH, PETE MICHAEL (RN)
Entity Type:Individual
Prefix:MR
First Name:PETE
Middle Name:MICHAEL
Last Name:ZENTKOVICH
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 1:5 SHELDON AVE
Mailing Address - Street 2:
Mailing Address - City:FAIRCHANCE
Mailing Address - State:PA
Mailing Address - Zip Code:15436-1022
Mailing Address - Country:US
Mailing Address - Phone:724-322-4401
Mailing Address - Fax:
Practice Address - Street 1:5 SHELDON AVE
Practice Address - Street 2:
Practice Address - City:FAIRCHANCE
Practice Address - State:PA
Practice Address - Zip Code:15436-1022
Practice Address - Country:US
Practice Address - Phone:724-322-4401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-20
Last Update Date:2017-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN583935163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty