Provider Demographics
NPI:1497242895
Name:ZYLINSKI, BRIAN L JR (DO)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:L
Last Name:ZYLINSKI
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 OXFORD XING STE 1
Mailing Address - Street 2:
Mailing Address - City:NEW HARTFORD
Mailing Address - State:NY
Mailing Address - Zip Code:13413-3200
Mailing Address - Country:US
Mailing Address - Phone:315-507-4751
Mailing Address - Fax:
Practice Address - Street 1:1 OXFORD XING STE 1
Practice Address - Street 2:
Practice Address - City:NEW HARTFORD
Practice Address - State:NY
Practice Address - Zip Code:13413-3200
Practice Address - Country:US
Practice Address - Phone:315-507-4751
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-20
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY307448207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1497242895Medicaid
MI1497242895Medicaid