MEDICARE: DR. DARIUSZ JASINSKI DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist	25MD00280100	NJ

General Provider Information

NPI Number	:	1013995182
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DARIUSZ JASINSKI DPM

Provider Business Mailing Address
First Line	:	184 COMLY RD
Second Line	:
City	:	LINCOLN PARK
State	:	NJ
Zip	:	07035-1104
Country	:	US
Telephone Number	:	201-406-7584
Fax Number	:	973-696-2433

Provider Business Practice Location Address
First Line	:	7 INDUSTRIAL ROAD
Second Line	:	SUITE 203
City	:	PEQUANNOCK
State	:	NJ
Zip	:	07440
Country	:	US
Telephone Number	:	201-406-7584
Fax Number	:	973-696-2433

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/09/2006
Last Update Date	:	11/28/2010

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