MEDICARE: DR. MICHAL SZYMON ZYLINSKI O.D.

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	008022	NY
2	152W00000X	Optometrist	TUV008022	NY

General Provider Information

NPI Number	:	1891137212
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAL SZYMON ZYLINSKI O.D.

Provider Business Mailing Address
First Line	:	128 RUSTIC PL
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10308-2840
Country	:	US
Telephone Number	:	718-371-8228
Fax Number	:

Provider Business Practice Location Address
First Line	:	1884 VICTORY BLVD
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10314-3514
Country	:	US
Telephone Number	:	718-273-5000
Fax Number	:

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

Provider Enumeration Date	:	07/26/2013
Last Update Date	:	03/14/2019

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