Healthcare Provider Details

I. General information

NPI: 1356459796
Provider Name (Legal Business Name): JAY M ZELINSKI D.O. PHD P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2006
Last Update Date: 11/05/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 KENNEDY BLVD
BAYONNE NJ
07002-1313
US

IV. Provider business mailing address

PO BOX 1275
BAYONNE NJ
07002-6275
US

V. Phone/Fax

Practice location:
  • Phone: 201-243-0445
  • Fax: 201-858-1002
Mailing address:
  • Phone: 201-243-0445
  • Fax: 201-858-1002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number25MB04874100
License Number StateNJ

VIII. Authorized Official

Name: JAY MICHAEL ZELINSKI
Title or Position: PRESIDENT/OWNER
Credential: D.O. PHD
Phone: 201-243-0445