Provider Demographics
NPI:1528386083
Name:ZIENKIEWICZ, PETER (PHARMD, RPH)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:
Last Name:ZIENKIEWICZ
Suffix:
Gender:M
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DENVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07834-2131
Mailing Address - Country:US
Mailing Address - Phone:973-625-0371
Mailing Address - Fax:973-625-0978
Practice Address - Street 1:22 W MAIN ST
Practice Address - Street 2:
Practice Address - City:DENVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07834-2131
Practice Address - Country:US
Practice Address - Phone:973-625-0371
Practice Address - Fax:973-625-0978
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-08
Last Update Date:2010-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03091500183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist