Provider Demographics
NPI:1992326789
Name:ZEISLOFT, KERBY (DO)
Entity type:Individual
Prefix:
First Name:KERBY
Middle Name:
Last Name:ZEISLOFT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 HAMILTON ST STE 301
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19130-3874
Mailing Address - Country:US
Mailing Address - Phone:215-774-1166
Mailing Address - Fax:
Practice Address - Street 1:2000 HAMILTON ST STE 301
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19130-3874
Practice Address - Country:US
Practice Address - Phone:215-774-1166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-03
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOT020432208000000X
PAOS023147208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics