Healthcare Provider Details

I. General information

NPI: 1215179445
Provider Name (Legal Business Name): COREY BRYAN ZATUCHNEY DVM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2009
Last Update Date: 04/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2135 RT 38 SUITE B
CHERRY HILL NJ
08002
US

IV. Provider business mailing address

2135 RT 38 SUITE B
CHERRY HILL NJ
08002
US

V. Phone/Fax

Practice location:
  • Phone: 856-317-0505
  • Fax: 856-317-0515
Mailing address:
  • Phone: 856-317-0505
  • Fax: 856-317-0515

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174M00000X
TaxonomyVeterinarian
License Number29VI00498800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: