Healthcare Provider Details

I. General information

NPI: 1245556745
Provider Name (Legal Business Name): JENNIFER LYNN ZUROSKY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2010
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

416 TYSON ST
CHARLOTTE NC
28209-2321
US

IV. Provider business mailing address

416 TYSON ST
CHARLOTTE NC
28209-2321
US

V. Phone/Fax

Practice location:
  • Phone: 864-363-8354
  • Fax:
Mailing address:
  • Phone: 864-363-8354
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License Number32370
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License Number76584
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License NumberDR.0063470
License Number StateCO
# 4
Primary TaxonomyN
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License NumberMED-PHYS-LIC-80882
License Number StateMT
# 5
Primary TaxonomyN
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License NumberMD20867
License Number StateRI
# 6
Primary TaxonomyN
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License Number01083429A
License Number StateIN
# 7
Primary TaxonomyY
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License Number2017-01644
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: