Healthcare Provider Details

I. General information

NPI: 1497242895
Provider Name (Legal Business Name): BRIAN L ZYLINSKI JR. DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2018
Last Update Date: 08/24/2022
Certification Date: 08/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 OXFORD XING STE 1
NEW HARTFORD NY
13413-3200
US

IV. Provider business mailing address

1 OXFORD XING STE 1
NEW HARTFORD NY
13413-3200
US

V. Phone/Fax

Practice location:
  • Phone: 315-507-4751
  • Fax:
Mailing address:
  • Phone: 315-507-4751
  • Fax:

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 Code207Q00000X
TaxonomyFamily Medicine Physician
License Number307448
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: