Provider Demographics
NPI:1134423809
Name:ZAUCHA, THOMAS W (PT)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:W
Last Name:ZAUCHA
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9 N 7TH ST
Mailing Address - Street 2:2ND FLOOR, TOWNPLACE VICTORIA
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15701-1880
Mailing Address - Country:US
Mailing Address - Phone:724-801-8894
Mailing Address - Fax:724-465-6032
Practice Address - Street 1:1265 WAYNE AVE
Practice Address - Street 2:119 PROFESSIONAL CENTER, SUITE 312
Practice Address - City:INDIANA
Practice Address - State:PA
Practice Address - Zip Code:15701-3501
Practice Address - Country:US
Practice Address - Phone:724-801-8894
Practice Address - Fax:724-465-6032
Is Sole Proprietor?:No
Enumeration Date:2011-01-10
Last Update Date:2012-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT002307L2251E1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251E1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistElectrophysiology, Clinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA207606YDYLMedicare PIN
PA207604Medicare PIN