Provider Demographics
NPI:1942432323
Name:ZIEJA, ANTHONY A (OD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:A
Last Name:ZIEJA
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7625
Mailing Address - Street 2:
Mailing Address - City:GILFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03247-7625
Mailing Address - Country:US
Mailing Address - Phone:603-524-2020
Mailing Address - Fax:603-528-2805
Practice Address - Street 1:368 HOUNSELL AVE
Practice Address - Street 2:
Practice Address - City:GILFORD
Practice Address - State:NH
Practice Address - Zip Code:03249-6922
Practice Address - Country:US
Practice Address - Phone:603-528-2606
Practice Address - Fax:603-528-2805
Is Sole Proprietor?:No
Enumeration Date:2009-08-18
Last Update Date:2010-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH832152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RE7048OtherGROUP PTAN
NH30357062Medicaid
NH1942432323OtherNPI
NH1295875383OtherGROUP NPI
NH1295875383OtherGROUP NPI