Provider Demographics
NPI:1225212954
Name:EDWARD ZAMECKI, INTERNAL MEDICINE & GERIATRICS, P.C.
Entity Type:Organization
Organization Name:EDWARD ZAMECKI, INTERNAL MEDICINE & GERIATRICS, P.C.
Other - Org Name:Z MEDICAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAMECKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-802-5562
Mailing Address - Street 1:128A GLEN ST
Mailing Address - Street 2:
Mailing Address - City:GLEN COVE
Mailing Address - State:NY
Mailing Address - Zip Code:11542-2737
Mailing Address - Country:US
Mailing Address - Phone:516-802-5562
Mailing Address - Fax:516-802-5563
Practice Address - Street 1:128A GLEN ST
Practice Address - Street 2:
Practice Address - City:GLEN COVE
Practice Address - State:NY
Practice Address - Zip Code:11542-2737
Practice Address - Country:US
Practice Address - Phone:516-802-5562
Practice Address - Fax:516-802-5563
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-17
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY193669207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG22018Medicare UPIN