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General NPI Number Information
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NPI Number | 1841483278
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Entity Type | Organization
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Legal Business Name | EDWARD ZIKOSKI EYE PROF OF WASHINGTON CROSSING
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Dates
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Enumeration Date | 08/20/2007
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Last Update Date | 06/18/2008
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Provider Practice Location Address
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Address Line | 1098 WASHINGTON CROSSING RD
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City | WASHINGTON XING
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State | PA
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Zip | 18977-1343
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Country | US
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Telephone | 215-493-0404
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Fax | 215-493-2033
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Provider Business Mailing Address
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Address Line | 1098 WASHINGTON CROSSING RD
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City | WASHINGTON XING
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State | PA
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Zip | 18977-1343
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Country | US
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Telephone | 215-493-0404
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Fax | 215-493-2033
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. EDWARD W. ZIKOSKI
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Credential | O.D.
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Telephone | 215-493-0404
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WP0200X
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Taxonomy Name | Pediatric Optometrist
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License Number | OEG000264
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OEG000264
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License Number State | PA
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