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Individual
BETHANY ELLEN ZISS
Active
Individual
BETHANY ELLEN ZISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MD454191
PA
2080P0006X
Developmental - Behavioral Pediatrics Physician
33473
SC
2080P0006X
Developmental - Behavioral Pediatrics Physician
Primary
MD454191
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1030053080001
—
PA
05
—
PENDING
—
SC
Enumeration date
06/17/2007
Last updated
10/09/2019
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