Provider Demographics
NPI:1225207863
Name:ZIENKOWSKI-ZUBEL, JENNIFER (DPM)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:
Last Name:ZIENKOWSKI-ZUBEL
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6551 WILSON MILLS RD STE 104
Mailing Address - Street 2:
Mailing Address - City:MAYFIELD VILLAGE
Mailing Address - State:OH
Mailing Address - Zip Code:44143-3425
Mailing Address - Country:US
Mailing Address - Phone:440-442-3113
Mailing Address - Fax:440-442-5137
Practice Address - Street 1:6551 WILSON MILLS RD STE 104
Practice Address - Street 2:
Practice Address - City:MAYFIELD VILLAGE
Practice Address - State:OH
Practice Address - Zip Code:44143-3425
Practice Address - Country:US
Practice Address - Phone:440-442-3113
Practice Address - Fax:440-442-5137
Is Sole Proprietor?:No
Enumeration Date:2008-02-28
Last Update Date:2019-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36003519213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2954558Medicaid
OHH114270Medicare PIN
OH4271261Medicare PIN