Provider Demographics
NPI:1356396949
Name:ZAMEROWSKI, MARK D (PT)
Entity type:Individual
Prefix:MR
First Name:MARK
Middle Name:D
Last Name:ZAMEROWSKI
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 1:860 ROUTE 168
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TURNERSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08012-3215
Mailing Address - Country:US
Mailing Address - Phone:856-228-8600
Mailing Address - Fax:856-228-9310
Practice Address - Street 1:860 ROUTE 168
Practice Address - Street 2:SUITE 100
Practice Address - City:TURNERSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08012-3215
Practice Address - Country:US
Practice Address - Phone:856-228-8600
Practice Address - Fax:856-228-9310
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2009-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00700300225100000X
PAPT010623L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ143586OtherMEDICARE PTAN
PA152995OtherMEDICARE PTAN
PAQ03949Medicare UPIN
PA091494K9LMedicare ID - Type Unspecified
NJ091494ZCLBMedicare PIN
PA152995OtherMEDICARE PTAN