Provider Demographics
NPI:1285765297
Name:ZMIERSKI, THOMAS (PT)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:
Last Name:ZMIERSKI
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9950 CALUMET AVE
Mailing Address - Street 2:
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321-4028
Mailing Address - Country:US
Mailing Address - Phone:219-762-7136
Mailing Address - Fax:219-934-2840
Practice Address - Street 1:1545 W US HIGHWAY 30
Practice Address - Street 2:
Practice Address - City:SCHERERVILLE
Practice Address - State:IN
Practice Address - Zip Code:46375-1562
Practice Address - Country:US
Practice Address - Phone:219-836-5381
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2020-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05002359A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN650020306OtherRR MEDICARE
IN000000178880OtherBLUE CROSS, BLUE SHIELD