MEDICARE: DR. STEVEN MARC ZODKOY D.C.

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	111NN1001X	Nutrition Chiropractor	38MC00395200	NJ

General Provider Information

NPI Number	:	1932251352
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN MARC ZODKOY D.C.

Provider Business Mailing Address
First Line	:	20 PALMER CIR
Second Line	:
City	:	MILLSTONE TOWNSHIP
State	:	NJ
Zip	:	07726-8547
Country	:	US
Telephone Number	:	732-446-8281
Fax Number	:

Provider Business Practice Location Address
First Line	:	503 STILLWELLS CORNER ROAD
Second Line	:
City	:	FREEHOLD
State	:	NJ
Zip	:	07728
Country	:	US
Telephone Number	:	732-308-0099
Fax Number	:	732-308-0347

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

Provider Enumeration Date	:	01/17/2007
Last Update Date	:	07/08/2007

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