Provider Demographics
NPI:1659608131
Name:ZOOB, PETER T (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:T
Last Name:ZOOB
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 LAKEVIEW RD
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06804-1510
Mailing Address - Country:US
Mailing Address - Phone:203-733-5369
Mailing Address - Fax:
Practice Address - Street 1:883 9TH AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-1704
Practice Address - Country:US
Practice Address - Phone:212-245-8469
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-04
Last Update Date:2009-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY051146183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist