Provider Demographics
NPI:1790972859
Name:JOEL ZARETZKY M.D.P.C.
Entity Type:Organization
Organization Name:JOEL ZARETZKY M.D.P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:ZARETZKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-735-5444
Mailing Address - Street 1:199 WAKELEE AVE
Mailing Address - Street 2:
Mailing Address - City:ANSONIA
Mailing Address - State:CT
Mailing Address - Zip Code:06401-1145
Mailing Address - Country:US
Mailing Address - Phone:203-735-5444
Mailing Address - Fax:203-735-1469
Practice Address - Street 1:199 WAKELEE AVE
Practice Address - Street 2:
Practice Address - City:ANSONIA
Practice Address - State:CT
Practice Address - Zip Code:06401-1145
Practice Address - Country:US
Practice Address - Phone:203-735-5444
Practice Address - Fax:203-735-1469
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-02
Last Update Date:2007-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT019620207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTC02297Medicare PIN
CTB83392Medicare UPIN