MEDICARE: DR. MARK I ZELNICK AU.D.

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	237600000X	Audiologist-Hearing Aid Fitter	452	NY

General Provider Information

NPI Number	:	1316015340
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARK I ZELNICK AU.D.

Provider Business Mailing Address
First Line	:	2204 FLATBUSH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-4516
Country	:	US
Telephone Number	:	718-252-0557
Fax Number	:

Provider Business Practice Location Address
First Line	:	2204 FLATBUSH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-4516
Country	:	US
Telephone Number	:	718-252-0557
Fax Number	:

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

Provider Enumeration Date	:	11/30/2006
Last Update Date	:	07/08/2007

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