Provider Demographics
NPI:1629134457
Name:ZINTERHOFER, LOUIS J (MD PHD)
Entity Type:Individual
Prefix:
First Name:LOUIS
Middle Name:J
Last Name:ZINTERHOFER
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 417
Mailing Address - Street 2:279 THIRD AVE SUITE 104
Mailing Address - City:LONG BRANCH
Mailing Address - State:NJ
Mailing Address - Zip Code:07740
Mailing Address - Country:US
Mailing Address - Phone:732-229-8711
Mailing Address - Fax:732-229-0245
Practice Address - Street 1:MONMOUTH MEDICAL CENTER DEPT OF PATHOLOGY
Practice Address - Street 2:300 SECOND AVENUE
Practice Address - City:LONG BRANCH
Practice Address - State:NJ
Practice Address - Zip Code:07740
Practice Address - Country:US
Practice Address - Phone:732-229-8711
Practice Address - Fax:732-229-0245
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA 27692207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3824705Medicaid
NJ3824705Medicaid
C58510Medicare UPIN