Healthcare Provider Details

I. General information

NPI: 1639628308
Provider Name (Legal Business Name): JAMES ZUKOWSKY
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2016
Last Update Date: 09/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

237 SOUTH STREET
MORRISTOWN NJ
07960-6098
US

IV. Provider business mailing address

237 SOUTH ST
MORRISTOWN NJ
07960-6098
US

V. Phone/Fax

Practice location:
  • Phone: 973-490-7827
  • Fax: 973-267-2273
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHP0234700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: