Healthcare Provider Details

I. General information

NPI: 1043479561
Provider Name (Legal Business Name): JOHN L. ZBOINSKI DPM, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2008
Last Update Date: 08/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

91 MONTGOMERY ST
RHINEBECK NY
12572-1122
US

IV. Provider business mailing address

91 MONTGOMERY ST
RHINEBECK NY
12572-1122
US

V. Phone/Fax

Practice location:
  • Phone: 845-876-8637
  • Fax: 845-876-0218
Mailing address:
  • Phone: 845-876-8637
  • Fax: 845-876-0218

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberN-005181
License Number StateNY

VIII. Authorized Official

Name: DR. JOHN L. ZBOINSKI
Title or Position: PRESIDENT
Credential: DPM
Phone: 845-876-8637