MEDICARE: JENNA CHRISTINE ZIELINSKI PT, DPT

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	225100000X	Physical Therapist	40QA01530000	NJ

General Provider Information

NPI Number	:	1578985636
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNA CHRISTINE ZIELINSKI PT, DPT

Provider Business Mailing Address
First Line	:	11 EAGLE ROCK AVE
Second Line	:
City	:	EAST HANOVER
State	:	NJ
Zip	:	07936-3167
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	867 SAINT GEORGES AVE
Second Line	:
City	:	RAHWAY
State	:	NJ
Zip	:	07065-2658
Country	:	US
Telephone Number	:	732-428-4008
Fax Number	:

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

Provider Enumeration Date	:	01/09/2014
Last Update Date	:	01/09/2014

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