Provider Demographics
NPI:1407826746
Name:ZUKOWSKI, CHRISTOPHER W (DO)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:W
Last Name:ZUKOWSKI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:150 AIRPORT ROAD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701
Mailing Address - Country:US
Mailing Address - Phone:732-942-9550
Mailing Address - Fax:732-942-9554
Practice Address - Street 1:150 AIRPORT ROAD
Practice Address - Street 2:SUITE 100
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701
Practice Address - Country:US
Practice Address - Phone:732-942-9550
Practice Address - Fax:732-942-9554
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2016-12-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MB03972000207QS0010X, 207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAD000Medicare UPIN