Provider Demographics
NPI:1275592792
Name:ZIERDEN-LANDMESSER, TERESA (DPM)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:ZIERDEN-LANDMESSER
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1085 N CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:HAZLE TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:18202-1465
Mailing Address - Country:US
Mailing Address - Phone:570-454-4677
Mailing Address - Fax:570-454-0796
Practice Address - Street 1:1085 N CHURCH ST
Practice Address - Street 2:
Practice Address - City:HAZLE TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:18202-1465
Practice Address - Country:US
Practice Address - Phone:570-454-4677
Practice Address - Fax:570-454-0796
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2011-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC003584L213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012509840003Medicaid
PA0012509840003Medicaid
PAU13011Medicare UPIN