Provider Demographics
NPI:1669660791
Name:THOMAS A ZOLDOWSKI DPM INC
Entity type:Organization
Organization Name:THOMAS A ZOLDOWSKI DPM INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:A
Authorized Official - Last Name:ZOLDOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:419-474-5462
Mailing Address - Street 1:2455 W SYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43613-4430
Mailing Address - Country:US
Mailing Address - Phone:419-474-5462
Mailing Address - Fax:419-474-4741
Practice Address - Street 1:2455 W SYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43613-4430
Practice Address - Country:US
Practice Address - Phone:419-474-5462
Practice Address - Fax:419-474-4741
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-15
Last Update Date:2010-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2948494Medicaid
OH0077901Medicaid
OHT80682Medicare UPIN
OH0136230001Medicare NSC
OHTH9237211Medicare PIN