Basic Information
| Provider Information | |||||||||
| NPI: | 1992865000 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ZENTZ | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | LOUIS | ||||||||
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| Credential: | M.S.,P.T. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 41 | ||||||||
| Address2: | |||||||||
| City: | SILVER LAKE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 145490041 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5855070106 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2333 STATE ROUTE 19 N | ||||||||
| Address2: | |||||||||
| City: | WARSAW | ||||||||
| State: | NY | ||||||||
| PostalCode: | 145699356 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5857868700 | ||||||||
| FaxNumber: | 5857862659 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/11/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 022703 | NY | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.