=====================================================
General NPI Number Information
=====================================================
NPI Number | 1366613747
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MARGARET ZAKANYCZ
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/13/2008
-----------------------------------------------------
Last Update Date | 01/14/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1300 HWY 35 PLAZA 1 SUITE 101
-----------------------------------------------------
City | OCEAN
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07712-3537
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-531-0490
-----------------------------------------------------
Fax | 732-531-9035
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1300 HWY 35 PLAZA 1 SUITE 101
-----------------------------------------------------
City | OCEAN
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07712-3537
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-531-0490
-----------------------------------------------------
Fax | 732-531-9035
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PODIATRIST
-----------------------------------------------------
Name | DR. MARGARET ZAKANYCZ
-----------------------------------------------------
Credential | D.P.M
-----------------------------------------------------
Telephone | 732-531-0490
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 213EP1101X
-----------------------------------------------------
Taxonomy Name | Primary Podiatric Medicine Podiatrist
-----------------------------------------------------
License Number | 25MD00125300
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------