MEDICARE: DR. IAN ZOLNOWSKI MD

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	207L00000X	Anesthesiology Physician	263570	NY

General Provider Information

NPI Number	:	1174784250
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. IAN ZOLNOWSKI MD

Provider Business Mailing Address
First Line	:	903 SUNSET RDG
Second Line	:
City	:	BRIDGEWATER
State	:	NJ
Zip	:	08807-1323
Country	:	US
Telephone Number	:	908-625-3298
Fax Number	:

Provider Business Practice Location Address
First Line	:	141 E 33RD ST APT 15C
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10016-4660
Country	:	US
Telephone Number	:	908-625-3298
Fax Number	:

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

Provider Enumeration Date	:	06/20/2008
Last Update Date	:	09/12/2022

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