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General NPI Number Information
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NPI Number | 1083810717
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Entity Type | Individual
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Provider Name | ZINAIDA VIKTORIA KOPYLENKO D.P.M.
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Gender | Female
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Dates
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Enumeration Date | 06/21/2007
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 95 BRIDGE PLAZA DR
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City | MANALAPAN
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State | NJ
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Zip | 07726-1700
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Country | US
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Telephone | 732-823-8769
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Fax | 732-851-5566
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Provider Business Mailing Address
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Address Line | 24 FORMAN LN
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City | MANALAPAN
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State | NJ
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Zip | 07726-2948
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Country | US
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Telephone | 347-645-3044
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Fax | 732-851-5566
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | N006210-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | 25MD00292700
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License Number State | NJ
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