Provider Demographics
NPI:1689238008
Name:SEMENETZ, ZACHARY JOSEPH (MD)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:JOSEPH
Last Name:SEMENETZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 BIDDLE AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-3967
Mailing Address - Country:US
Mailing Address - Phone:302-836-7820
Mailing Address - Fax:302-836-7826
Practice Address - Street 1:200 BIDDLE AVE STE 100
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-3967
Practice Address - Country:US
Practice Address - Phone:302-836-7820
Practice Address - Fax:302-836-7826
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-01
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0025089208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty