Healthcare Provider Details

I. General information

NPI: 1881183895
Provider Name (Legal Business Name): SIANA LUCILLE ZIEMBA DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2018
Last Update Date: 10/11/2023
Certification Date: 10/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 CHAMBERS AVE
CAMDEN NJ
08103-1405
US

IV. Provider business mailing address

1 FEDERAL ST STE 200
CAMDEN NJ
08103-1088
US

V. Phone/Fax

Practice location:
  • Phone: 856-342-2328
  • Fax: 856-361-1982
Mailing address:
  • Phone: 848-288-6935
  • Fax: 732-790-0107

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number25MB11294500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: