MEDICARE: ZACHARY CRISWELL 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	007140	NY

General Provider Information

NPI Number	:	1023429651
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZACHARY CRISWELL DPM

Provider Business Mailing Address
First Line	:	3065 ROUTE 50
Second Line	:
City	:	SARATOGA SPRINGS
State	:	NY
Zip	:	12866-2960
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3065 ROUTE 50
Second Line	:
City	:	SARATOGA SPRINGS
State	:	NY
Zip	:	12866-2960
Country	:	US
Telephone Number	:	518-584-1590
Fax Number	:

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

Provider Enumeration Date	:	05/16/2014
Last Update Date	:	03/07/2025

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Directions to “ ZACHARY CRISWELL DPM” Practice Location

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