Provider Demographics
NPI:1912948670
Name:ZEKONIS, ROBERT (MPT)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:
Last Name:ZEKONIS
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:254 WEST LANCASTER AVENUE
Mailing Address - Street 2:PO BOX 666
Mailing Address - City:PAOLI
Mailing Address - State:PA
Mailing Address - Zip Code:19301-0968
Mailing Address - Country:US
Mailing Address - Phone:610-296-5300
Mailing Address - Fax:610-408-8968
Practice Address - Street 1:254 WEST LANCASTER AVENUE
Practice Address - Street 2:
Practice Address - City:PAOLI
Practice Address - State:PA
Practice Address - Zip Code:19301-0968
Practice Address - Country:US
Practice Address - Phone:610-296-5300
Practice Address - Fax:610-408-8968
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT007221L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA705367OtherHIGHMARK BLUE SHIELD
PA0541100000OtherINDEPENDENCE BLUE CROSS