MEDICARE: DR. MARK ZIENTEK 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	111NX0800X	Orthopedic Chiropractor	38MC00273600	NJ

General Provider Information

NPI Number	:	1972500379
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARK ZIENTEK D.C.

Provider Business Mailing Address
First Line	:	1082 SAINT GEORGES AVE
Second Line	:
City	:	RAHWAY
State	:	NJ
Zip	:	07065-2664
Country	:	US
Telephone Number	:	732-388-4344
Fax Number	:	732-388-4380

Provider Business Practice Location Address
First Line	:	1082 SAINT GEORGES AVE
Second Line	:
City	:	RAHWAY
State	:	NJ
Zip	:	07065-2664
Country	:	US
Telephone Number	:	732-388-4344
Fax Number	:	732-388-4380

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

Provider Enumeration Date	:	06/30/2005
Last Update Date	:	08/16/2010

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