Provider Demographics
NPI:1902794340
Name:ZISUH, PETER
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:
Last Name:ZISUH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4066 WARNER AVE APT D6
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20784-1924
Mailing Address - Country:US
Mailing Address - Phone:202-498-1911
Mailing Address - Fax:
Practice Address - Street 1:4066 WARNER AVE APT D6
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20784-1924
Practice Address - Country:US
Practice Address - Phone:202-498-1911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-25
Last Update Date:2025-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide