Provider Demographics
NPI:1356459796
Name:JAY M ZELINSKI D.O. PHD P.C.
Entity Type:Organization
Organization Name:JAY M ZELINSKI D.O. PHD P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAY
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:ZELINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DO PHD
Authorized Official - Phone:201-243-0445
Mailing Address - Street 1:PO BOX 1275
Mailing Address - Street 2:
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002-6275
Mailing Address - Country:US
Mailing Address - Phone:201-243-0445
Mailing Address - Fax:201-858-1002
Practice Address - Street 1:350 KENNEDY BLVD
Practice Address - Street 2:
Practice Address - City:BAYONNE
Practice Address - State:NJ
Practice Address - Zip Code:07002-1313
Practice Address - Country:US
Practice Address - Phone:201-243-0445
Practice Address - Fax:201-858-1002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-27
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB04874100207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
F36089Medicare UPIN
010360Medicare PIN