Healthcare Provider Details

I. General information

NPI: 1710013834
Provider Name (Legal Business Name): PETER ZORACH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/25/2007
Last Update Date: 09/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

495 E MAIN ST
MIDDLETOWN DE
19709-1463
US

IV. Provider business mailing address

PO BOX 337
MONTCHANIN DE
19710-0337
US

V. Phone/Fax

Practice location:
  • Phone: 302-377-5874
  • Fax: 302-655-4027
Mailing address:
  • Phone:
  • Fax: 302-655-4027

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberC10004422
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: