Provider Demographics
NPI:1760529077
Name:ZAPOTOCHNY, TERESA M (PT)
Entity Type:Individual
Prefix:MS
First Name:TERESA
Middle Name:M
Last Name:ZAPOTOCHNY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 S HENDERSON RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-3530
Mailing Address - Country:US
Mailing Address - Phone:610-768-5940
Mailing Address - Fax:610-768-5947
Practice Address - Street 1:1888 MARLTON PIKE E
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-2178
Practice Address - Country:US
Practice Address - Phone:856-489-5930
Practice Address - Fax:856-489-5631
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT015213225100000X
NJ40QA00621200225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1704227OtherIBC - PERSONAL CHOICE
PA2374653000OtherIBC-KEYSTONE