Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | MD458446 | PA |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | MD458446 | PA |
NPI | 1144535139 |
---|---|
Provider Name | Zachary Walsh Sisko |
First Address | Jefferson Hills, PA 15025-3747 |
Second Address | Jefferson Hills, PA 15025-3747 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2010 |
Last Update Date | 08/10/2020 |