Provider Demographics
NPI:1114227725
Name:EDWARD M. ZAWADZKI, D.O., P.A.
Entity Type:Organization
Organization Name:EDWARD M. ZAWADZKI, D.O., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:M
Authorized Official - Last Name:ZAWADZKI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:516-435-7192
Mailing Address - Street 1:248 W BAY CEDAR CIR
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-7123
Mailing Address - Country:US
Mailing Address - Phone:516-435-7192
Mailing Address - Fax:
Practice Address - Street 1:248 W BAY CEDAR CIR
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-7123
Practice Address - Country:US
Practice Address - Phone:516-435-7192
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-28
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS105572084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty