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NPI Code Detail

MEDICARE: DR. JENNIFER ZOFIA GRZESIK DPM

MEDICARE: DR. JENNIFER ZOFIA GRZESIK DPM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1213EP1101XPrimary Podiatric Medicine Podiatrist007184-01NY

General Provider Information

NPI Number : 1023579240
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JENNIFER ZOFIA GRZESIK DPM
Provider Business Mailing Address
First Line : 491 FLUSHING AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11205-1610
Country : US
Telephone Number : 718-858-3338
Fax Number :
Provider Business Practice Location Address
First Line : 491 FLUSHING AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11205-1610
Country : US
Telephone Number : 718-858-3338
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/29/2019
Last Update Date : 07/11/2024

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