Provider Demographics
NPI:1619137494
Name:ZNAMENSKY, ADDI (MD)
Entity Type:Individual
Prefix:
First Name:ADDI
Middle Name:
Last Name:ZNAMENSKY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ADDI
Other - Middle Name:
Other - Last Name:LAVOTSHKIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:757 TEANECK RD.
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666
Mailing Address - Country:US
Mailing Address - Phone:201-833-2288
Mailing Address - Fax:
Practice Address - Street 1:757 TEANECK RD.
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666
Practice Address - Country:US
Practice Address - Phone:201-833-2288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-14
Last Update Date:2014-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1619137494207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine