Provider Demographics
NPI:1598710295
Name:ZYSMAN, JULES (MD)
Entity Type:Individual
Prefix:
First Name:JULES
Middle Name:
Last Name:ZYSMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 ONTARIO STREET
Mailing Address - Street 2:
Mailing Address - City:HONEOYE FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14472
Mailing Address - Country:US
Mailing Address - Phone:585-624-2121
Mailing Address - Fax:585-624-7283
Practice Address - Street 1:23 ONTARIO STREET
Practice Address - Street 2:
Practice Address - City:HONEOYE FALLS
Practice Address - State:NY
Practice Address - Zip Code:14472
Practice Address - Country:US
Practice Address - Phone:585-624-2121
Practice Address - Fax:585-624-7283
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2020-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY136953207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00677312Medicaid
NY100846BFOtherPREFERRED CARE
NYP010136953OtherBLUE CHOICE
NYP010136953OtherBLUE CHOICE
B74983Medicare UPIN