Healthcare Provider Details
I. General information
NPI: 1538986807
Provider Name (Legal Business Name): BRIAN L ZYLINSKI DO PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/26/2024
Last Update Date: 09/26/2024
Certification Date: 09/26/2024
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
- Phone: 315-507-4751
- Fax: 315-765-6056
- Phone: 315-507-4751
- Fax: 315-765-6056
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 204D00000X |
| Taxonomy | Neuromusculoskeletal Medicine & OMM Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208D00000X |
| Taxonomy | General Practice Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
BRIAN
L
ZYLINSKI
Title or Position: SOLE OWNER
Credential: DO
Phone: 315-507-4751