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NPI Code Detail

MEDICARE: MARCIN MAREK ZYGAWSKI M.D.

MEDICARE: MARCIN MAREK ZYGAWSKI M.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
1174400000XSpecialist231111-1NY
2207W00000XOphthalmology Physician231111-1NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1396747556
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARCIN MAREK ZYGAWSKI M.D.
Provider Business Mailing Address
First Line : 740 WILLIAMS ST
Second Line : SUITE #3
City : PITTSFIELD
State : MA
Zip : 01201-7463
Country : US
Telephone Number : 413-445-4564
Fax Number : 413-448-2727
Provider Business Practice Location Address
First Line : 740 WILLIAMS ST
Second Line : SUITE #3
City : PITTSFIELD
State : MA
Zip : 01201-7463
Country : US
Telephone Number : 413-445-4564
Fax Number : 413-448-2727
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2005
Last Update Date : 09/22/2015

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