Healthcare Provider Details

I. General information

NPI: 1306860838
Provider Name (Legal Business Name): JONATHAN ERIC ZEICHNER D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

57 E 72ND ST 1 B
NEW YORK NY
10021-4122
US

IV. Provider business mailing address

57 E 72ND ST 1 B
NEW YORK NY
10021-4122
US

V. Phone/Fax

Practice location:
  • Phone: 212-772-3355
  • Fax: 212-772-3357
Mailing address:
  • Phone: 212-772-3355
  • Fax: 212-772-3357

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number031494
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: