Provider Demographics
NPI:1811231608
Name:ZIEGELBAUM, ROBERT MALLER (PT)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:MALLER
Last Name:ZIEGELBAUM
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 MEADOWBROOK RD
Mailing Address - Street 2:
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-2117
Mailing Address - Country:US
Mailing Address - Phone:516-732-0063
Mailing Address - Fax:
Practice Address - Street 1:75 MEADOWBROOK RD
Practice Address - Street 2:
Practice Address - City:SYOSSET
Practice Address - State:NY
Practice Address - Zip Code:11791-2117
Practice Address - Country:US
Practice Address - Phone:516-732-0063
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-16
Last Update Date:2017-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0351281225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist