Healthcare Provider Details

I. General information

NPI: 1164050704
Provider Name (Legal Business Name): SANDRA ZAWADKA DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2020
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

535 PLANDOME RD # 2
MANHASSET NY
11030-1974
US

IV. Provider business mailing address

PO BOX 356
SYOSSET NY
11791-0356
US

V. Phone/Fax

Practice location:
  • Phone: 516-365-5544
  • Fax:
Mailing address:
  • Phone: 347-383-8607
  • Fax: 763-445-2305

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License NumberN007256
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: