Provider Demographics
NPI:1770580938
Name:ZAJKOWSKI, EDWARD JOSEPH (MD,MPH)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:JOSEPH
Last Name:ZAJKOWSKI
Suffix:
Gender:M
Credentials:MD,MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:393 LYNN ST
Mailing Address - Street 2:
Mailing Address - City:HARRINGTON PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07640-1119
Mailing Address - Country:US
Mailing Address - Phone:201-767-0364
Mailing Address - Fax:201-928-4227
Practice Address - Street 1:197 CEDAR LN
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-4301
Practice Address - Country:US
Practice Address - Phone:201-836-7171
Practice Address - Fax:201-928-4227
Is Sole Proprietor?:No
Enumeration Date:2005-07-02
Last Update Date:2015-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA050051002080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
10668020OtherCAQH
NJ0564401Medicaid
NJB20178Medicare UPIN