Healthcare Provider Details

I. General information

NPI: 1154302149
Provider Name (Legal Business Name): ZUCKER HORSLEY TATEM ALTHOFF PROFESSIONAL CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 W 6TH ST STE A-2
RENO NV
89503-4519
US

IV. Provider business mailing address

350 W 6TH ST STE A-2
RENO NV
89503-4519
US

V. Phone/Fax

Practice location:
  • Phone: 775-329-2525
  • Fax: 775-348-0740
Mailing address:
  • Phone: 775-329-2525
  • Fax: 775-348-0740

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. MARY J MCGRATH
Title or Position: OFFICE MANAGER
Credential:
Phone: 725-329-1375