MEDICARE: DR. CHARLES L ZOLOT OD

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
1	152W00000X	Optometrist	3508	NJ

General Provider Information

NPI Number	:	1548254808
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHARLES L ZOLOT OD

Provider Business Mailing Address
First Line	:	1 COURTER RD
Second Line	:
City	:	FRANKLIN LAKES
State	:	NJ
Zip	:	07417-1813
Country	:	US
Telephone Number	:	201-891-1747
Fax Number	:

Provider Business Practice Location Address
First Line	:	22 MADISON AVE
Second Line	:
City	:	PARAMUS
State	:	NJ
Zip	:	07652-2734
Country	:	US
Telephone Number	:	201-845-7110
Fax Number	:	201-909-8618

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/01/2005
Last Update Date	:	03/08/2008

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