Provider Demographics
NPI:1346694601
Name:PFIZENMAYER, JOHN ANTHONY
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:ANTHONY
Last Name:PFIZENMAYER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 PERSIMMON DR
Mailing Address - Street 2:
Mailing Address - City:SEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08080-3058
Mailing Address - Country:US
Mailing Address - Phone:856-723-0033
Mailing Address - Fax:
Practice Address - Street 1:535 IRVING SCHOTTENSTEIN DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43210-1044
Practice Address - Country:US
Practice Address - Phone:856-723-0033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-22
Last Update Date:2016-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer