Individual
DR. ZISSIE SIOKOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
860 E SWEDESFORD RD, SUITE 100, WAYNE, PA 19087-2130
(610) 265-2020
(610) 265-4054
Mailing address
369 GREEN LANE, PHILADELPHIA, PA 19128
(215) 421-7755
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
PAOEG1082
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0017617980005
—
PA
Enumeration date
10/03/2006
Last updated
10/30/2007
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